Home Insurance Claims Advice and Help

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Home Insurance Claims Are Disagreeable

Policy holders want insurer’s money and insurer’s adjusters want to save insurer’s money. That’s inherently disagreeable. The word “adjuster” as used in “insurance adjuster” means to alter or change. In insurance, it is usually a “downward” adjustment of your claim. The word “claim” as used in “insurance claim” means to ask for something. As national radio talk show financial advisor Bruce Williams has said “you don’t ask … you don’t get”. And, as “The Donald” says, “it’s not personal, it’s just business.”

Myths

While insurers have a legal duty to act in good faith and answer your questions about the policy truthfully, they are not obligated to tell you what to claim. The “agent” who sold you your policy is legally, not really “your” agent. He is, legally, the insurer’s agent. The only motivation for him to help you is the 2%-5% commission he earns on the premiums you pay. And those commissions are paid by the insurer after your check goes to the insurer.

Your Attitude and Morale

So, here you are in a motel or a rental house after your small kitchen fire or major house fire. It’s been six days and no one is returning your calls. Maybe it’s been six months and they are still “getting estimates” or doing investigation. Maybe they are investigating YOU. They may have advanced you some money, but it probably wasn’t enough. You never thought you would be sick of eating out. If you are unhappy, that’s a pretty good sign you need help.

But maybe everything is going great so far, so you think. Well let me tell you this: the difference between a good insurance company adjuster and a poor one. The good adjuster will walk into your house and within five minutes his eyes have seen ten things he could pay you for when your claim was only for two things: a water stain on your ceiling and a wet carpet. The good adjuster will add a couple more items to your claim and you will be very happy. A bad adjuster will also see ten things you could be paid for, but not only will he NOT mention the additional items, he will look for a way to reduce and deny your two items. But the real point here is that there is always money left on the table.

Still feel guilty? Look, there’s a pot of gold in your insurance policy, insurance law and construction knowledge. You don’t have to do anything illegal or unethical. I guarantee you when an insurance company executive or adjuster has a claim to his own home, he gets every last penny. They even call me for free advice (in confidence) if you can believe that!

Regardless of whether you are dealing with a good or bad adjuster, you need to arm yourself with the knowledge and the confidence you will get from a UClaim home insurance claims advice eBook.

 

2,461 Responses to “Home Insurance Claims Advice and Help”

  1. 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.

  2. 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.

  3. 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?

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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?

  10. 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 UClaim.com .

    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.

  11. 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

  12. 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

  13. 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 UClaim.com. Click on the link entitled “About Public Adjusters” on the Considerations page. 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.

  14. 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 UClaim.com . 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.

  15. 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?

  16. 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)

  17. 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 UClaim.com . 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.

  18. 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 UClaim.com .

    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.

  19. 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.

  20. 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.

  21. 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?

  22. 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?

  23. 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.

  24. 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.

  25. 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 UClaim.com . 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.

  26. 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.

  27. 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

  28. 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.

  29. 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 UClaim.com 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.

  30. 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!

  31. 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.

  32. 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!

  33. 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?

  34. 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 UClaim.com and read the detailed discussion on this.

  35. 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.

  36. 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

  37. 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.

  38. 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.

  39. 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.

  40. 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 UClaim.com . 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.

  41. January 19th, 2009 at 3:59 pm #Kelly

    Kuykendall,
    Would your insurance allow you to rebuild on a different piece of real estate?

  42. 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.

  43. 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 UClaim.com and consider the Homeowners Loss Standard or Deluxe guide. You will learn the tricks that public adjusters use.

  44. 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).

  45. 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.

  46. 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

  47. 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 UClaim.com , and found no limitation there. And I think you are ok on the contents too. Let us know if something is denied and why.

  48. 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.

  49. 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.

  50. 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!

  51. 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.

  52. 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

  53. 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)”.

  54. 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.

  55. 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).

  56. 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.

  57. 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?

  58. 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.

  59. 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!

  60. 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.

  61. 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

  62. 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!

  63. 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.

  64. 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.

  65. 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

  66. 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

  67. 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…

  68. 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

  69. 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.

  70. 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.

  71. 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.

  72. 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.

  73. 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)

  74. 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

  75. 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

  76. 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

  77. 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.

  78. 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)”.

  79. 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.

  80. 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

  81. 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.

  82. 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-

  83. 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 UClaim.com .

  84. 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

  85. 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 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.

  86. 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.

  87. 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 .

  88. 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

  89. 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?

  90. 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.

  91. 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.

  92. 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.

  93. 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.

  94. 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?

  95. 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!

  96. 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 UClaim.com .

    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.

  97. 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.

  98. 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…

  99. 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 UClaim.com .

  100. 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?

  101. 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.

  102. 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?

  103. 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 Considerations page at 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.

  104. 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.

  105. 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?

  106. 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.

  107. 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 Considerations page at 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?

  108. 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

  109. 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.

  110. 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.

  111. 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 Considerations 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 .

  112. 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

  113. 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.

  114. 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?

  115. 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?

  116. June 2nd, 2009 at 12:01 pm #jaws5738

    This was a hail storm, by the way. I left that out of the original post!

  117. 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 .

  118. 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.

  119. 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???

  120. 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?

  121. 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.

  122. 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.

  123. 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!

  124. 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.

  125. 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.

  126. 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.

  127. 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

  128. 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.

  129. 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

  130. 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.

  131. 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.

  132. 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”?

  133. 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!

  134. 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

  135. 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

  136. 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.

  137. 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.

  138. 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.

  139. 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

  140. 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

  141. 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

  142. 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!

  143. 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.

  144. 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.

  145. August 13th, 2009 at 7:26 pm #admin

    Hello all,

    Check out our new discussion forum here at insuranceclaimhelp.org!

  146. 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

  147. 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.

  148. 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?

  149. 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?

  150. 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.

  151. 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?

  152. 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.

  153. 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.

  154. 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.

  155. 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

  156. 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.

  157. 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?

  158. 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.

  159. 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?

  160. 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!

  161. 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.

  162. 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!

  163. 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 🙂

  164. 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.

  165. 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

  166. 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.

  167. 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.

  168. 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.

  169. 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……….

  170. 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?

  171. 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.

  172. 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

  173. 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?

  174. 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.

  175. 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.

  176. 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.

  177. 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.

  178. 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.

  179. 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.

  180. 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.

  181. 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.

  182. 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?

  183. 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?

  184. 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.

  185. 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.

  186. 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.

  187. 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

  188. 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…..

  189. 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!!!

  190. 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.

  191. 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?

  192. 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.”

  193. 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?

  194. 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).

  195. 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!

  196. 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….

  197. 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.

  198. 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

  199. 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“.

  200. 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.

  201. December 16th, 2009 at 7:26 pm #admin

    TRB,

    Anyone want to chime in on TRB’s situation? How about you Mr. Green?

  202. 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

  203. 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.

  204. 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.

  205. 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

  206. 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

  207. 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?

  208. 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.

  209. 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.

  210. January 15th, 2010 at 3:12 am #mandy

    my daughter sat on the sofa and busted it can u claim of the house insurance

  211. 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

  212. 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.

  213. 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.

  214. 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.

  215. 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.

  216. 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.

  217. January 29th, 2010 at 6:05 am #f. michael conte,CPIA

    Ditto!!!!!!

    fmc

  218. 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!

  219. 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?

  220. 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

  221. 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

  222. 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?

  223. 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

  224. 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.

  225. 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.

  226. 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.

  227. 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 https://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?

  228. February 18th, 2010 at 7:40 pm #F MICHAEL CONTE

    thanks for the good words. please let us know the out come.

  229. 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?

  230. 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.

  231. 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!

  232. 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.

  233. 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.

  234. 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.”

  235. 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.

  236. 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!

  237. 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.

  238. 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?

  239. 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,

  240. 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.

  241. March 10th, 2010 at 1:05 pm #cm

    I have a rental and in two yrs the property only had two tenant for short times less than a yr each about half yr. inbetween a lamp wire was faulty and burned a whole in the floor,,first claim, then person was welding in bathroom and must likely an amber was in wall fire on second floor, accident second claim, recently notice someone broke in home and stole cooper pipes, made a police report and put up signs no trespassing and resecured home and next day or so someone broke in and started a fire in basement and still under investagation,,I even got questioned and I feel instead of the police or ins. investagor looking for the vacrant then look at the home owner I understand some people may do this in this economy but what about innocent people like me that have a bad luck on things..being a older home that is empty most of the time it is more likely things will happen,,I feel like I am the accused and I have been so cooperative and answering all questions and giving all papers as needed even though I am innocent and I am getting confussed on certain times and dates and how the events unfolded ,,I have never been behind in morgage or taxes or bills and I have never been questioned it is scary to me, and I got a letter which they call standard that says there may be a claim issue re read the policy if I did it or directed someone to,,,which is a slap in the face to me,,,the call this a standard letter ,,I feel at this point I am being accused of something so horrible,,and they have no reserve on acct or claim yet and it is almost two months ,,is this typical/ and any suggestions…thanks

  242. March 11th, 2010 at 6:45 pm #Needing Help

    Hi,

    I am so grateful for a site like this that is designed to help us with information insurers aren’t so forthcoming with.

    I have three short questions:

    Can I act as my own general contractor and hire and pay subcontractors to do the work my insurance has approved and sent money to my mortgage company for?

    If so, am I required to turn a W-9 along with a draw schedule? Is there anything else I should know, or additional paperwork I need to turn in?

    Thanks for your help

  243. March 12th, 2010 at 3:44 am #admin

    Dear Needing,

    You know, of all the people who arrived at this free website today with the same google search phrase as you, you were the only one patient enough to even type up your question. You just may have have a shot at not getting outsmarted by your insurer! Here’s your answers:

    Yes, no and yes, IMO (and with those over simplistic short answers, I must say, for liability reasons, consult with an attorney before making final decisions).

    There is a detailed discussion on how to handle your situation in one of the eBooks at UClaim.com entitled “Homeowners Loss …”. If this is your only problem with your claim, then the standard version will suffice. Look at the table of contents online. The eBooks have a money back guarantee and free consultation/s with the author.

    It explains in layman terms how to “act as your own contractor” and get that 20% P&O as well as doing the repairs for less than the insurer estimated, without getting yourself into legal trouble as well as getting outsmarted by the adjuster.

    Let us know how it ends up for you.

  244. March 12th, 2010 at 2:03 pm #Needing Help

    Hello again,

    This is “Needs Help” needing more…help!

    Ok, the insurance company says they need the name of the person/company who is going to do the work so they can put both our names on the draw checks.

    I was thinking about having the Home Depot do the work but they don’t deal with the insurance/mortgage company for payment, only me. But if I cannot turn their name and necessary information in to the mortgage company to get their name on the draw checks, and if the mortgage company won’t release the funds without their information, what am I to do?!

    Signed,

    Needs Help Again

  245. March 12th, 2010 at 5:30 pm #Reni Fulton

    3 story concrete block building on property,insured for removal only collapsed under snow weight. SF agent not cooperative in making a claim on my behalf. Says that he never should have insured it! Also have concern that SF will say that we did nothing to maintain it. But the building’s top two stories were were not usable. Same agent inspected and insured building for removal only. What are my options if agent continues to be uncooperative or SF refuses to pay claim? Thanks

  246. March 13th, 2010 at 3:20 pm #admin

    Dear Needing,

    How much money would you stand to gain by doing your own repairs? At least 20% for the contractor P&O, right? Plus whatever amount more by beating the insurance adjusters estimate, right? It could be many thousands of dollars, right?

    And guess what else you probably never thought of, most insurers only pay the “ACV”, the depreciated amount of the repairs up front. So the mortgage company may only be holding 60% of the money for the estimated repairs. When the repairs are done, the insurer will send the mortgage company and you the other 40%, right? Well the answer is MAYBE. What the adjuster never tells you (until the end), or buries, is the policy provision that says the insurer only owes the “lesser” final settlement amount, and the lesser amount is “the amount actually spent”. So if you busted your rear end to come out ahead with money in your pocket, then you got screwed! In effect you helped the insurance company save its money, and you worked for the insurance company, for free! Congratulations.

    Why would it not make sense to spend $79.00 on an eBook by a highly successful California public adjuster, with a money back guarantee, and free consultations by the author, at UClaim.com, that would answer all your questions and more to come on this one subject, as well as cover ALL the other aspects of a homeowners insurance claim that can add dollars in your pocket … and … keep you out of trouble with the law and your insurer??? Talk about looking a gift horse in the mouth. Where else on the internet are you going to find eBooks by an author who has laid it all out for everyone to see? How many fancy public adjuster websites have you seen that essentially tell you nothing more about the public adjuster than his membership in a trade organization with a logo that any public adjuster can buy for $500.00? And Needing, there are sadly many public adjusters out there whose only real prior “insurance claims experience” was cleaning wet carpets for Service Master! It’s a jungle out there dear Needing.

    I’d really like to know the answer, because most of the visitors to this website are exactly like you, looking for a couple of short quick “fix all” answers on the internet. Please, educate me, if for nothing else, call it a trade for the small bit of information I’m about to give you below.

    1. The insurer is legally bound to protect the mortgage company. It’s in your policy. Your mortgagee is (or should be) named on your declarations page. Without them named on your policy, you would not have gotten your loan. So a prudent insurer either will name the mortgagee or a contractor in addition to your name on large building structure checks.

    2. The mortgagee just wants to insure that the repairs are done so their collateral (“your” house) can be protected. The only way to get the mortgage company to release that money, without a contractor, is for YOU to complete the repairs in increments, then you call the bank to send their inspector out to verify the repairs for each increment. Then you get reimbursed, for that increment. So YOU front the money, or your subcontractors agree to wait for payment. Most won’t wait over 30 days.

    But Needing, there are a couple more pages of very important information on this issue I could give you, but just don’t have the time.

    And PLEASE give us your honest answer on my above question. We obviously need help in making people like you break out of that “penny wise pound foolish” mentality. We can’t write a treatise on every question and we can’t be everyone’s free personal consultant.

  247. March 13th, 2010 at 4:06 pm #admin

    Reni,

    I’ve never seen a policy or endorsement for “removal only”. If you want us to take a look, please attach to an email a scanned copy to info@insuranceclaimhelp.org .

    Get the denial in writing, and it has to state specifically the reason, for example policy clause xyz or such and such law. After that, if you are going to pursue the claim without a public adjuster or lawyer, then get the eBook on denied home and business claims at UClaim.com. Litigation should always be “the last” resort.

  248. March 15th, 2010 at 5:00 am #f. michael conte,CPIA

    I would love to see this policy or endorsement as well, as i have never seen such a policy either.
    fmc

  249. March 16th, 2010 at 2:02 pm #MATT GODDARD

    I HAVE AN INSURANCE CLAIM WITH FARMERS INSURANCE AND MY CONTRACTOR STATES THEY ARE PAYING TOO LITTLE FOR HIM TO COMPLETE THE WORK. I HAVE CONTACTED FARMERS TO DISCUSS THIS AND THEY CLAIM THEY ARE PAYING FAIR MARKET VALUE FOR THE DAMAGE AND EVERY CONTRACTOR I TALK TO DISAGREES WITH FARMERS. MY CONTRACTOR IS ALSO A GENERAL CONTRACTOR AND HE STATES THAT FARMERS IS REQUIRED TO PAY CONTRACTORS OVERHEAD AND PROFIT. IS THERE ANYTHING I CAN DO TO FORCE FARMERS TO SETTLE UP WITH MY CONTRACTOR SO I CAN GET MY HOME REPAIRED.

  250. March 16th, 2010 at 11:25 pm #admin

    Matt,

    If you are saying Farmers is denying P&O, even to licensed contractors, we would all like to know what state you are in. That is some pretty serious stuff. I thought Farmers was pretty cheap by not paying P&O to owner builders in some areas, but to not pay contractors? You can check this with your state DOI and hope for the best, but the fact is that most states DOI suck up to insurers.

    You can’t “force” an insurer to do anything. They can hire 1000 attorneys to beat down your one attorney and buy off the judge if they want to. You have to outsmart them if you want to beat them. That’s how good public adjusters and attorneys beat them.

  251. March 17th, 2010 at 5:31 am #cm

    rental home had a fire for third time within short time,,bad luck home,,vacant so it is more likely to have problem,,as a victim, I feel that my ins co is trying to get out of claim, I gave to fire marshall and ins investagator all ans. and paperwork that I could gather together,,they made me nerous and I am innocent and shouldn’t be but I have never been questioned before and it is understandable that in this economy that people are doing there jobs and checking all possibilities but they shouldn’t make the home owner who pays taxes and ins for yrs feel terrible,,do I need a lawyer and what is expected next? what type of lawyer would I need? this is a long process I assume and I never went through this before, so if anyone went through this maybe you can give me advice thanks

  252. March 20th, 2010 at 1:34 pm #F MICHAEL CONTE

    get a lawyer, someone who has experiance in insurance property matters.
    fmc

  253. March 20th, 2010 at 1:38 pm #admin

    CM,

    The most important advice is to keep the house “occupied”. Because vandalism and arson by vandalism will be resisted or denied by the insurer if the house is “vacant” or “unoccupied”, usually for over 30 days. You can “occupy” the house by having work or remodel work done on it. Stop by the place every few days and do a little something. If you want to make a stronger argument, spend the night there, you or somebody you know, every couple of weeks.

    It doesn’t matter if you are a decorated veteran and were in Disneyland when the fires occurred, they can still run you though the mill and encourage you to give up your claim. If you can’t afford a good public adjuster and or attorney, get the eBooks at UClaim.com on Landlord Rental Property Loss, Denied Homeowner and Businessowner Claims, and the one on EOU (if they demand EUO, and they probably will in your case).

  254. March 20th, 2010 at 6:24 pm #cm

    what if you were trying to sell it?

  255. March 21st, 2010 at 4:57 am #admin

    CM,

    Makes no difference. If you are suggesting that showing potential buyers the property might fit the policy description of the word “occupied”, I think you might be hard pressed to convince an insurer, judge or court of that.

    And if anything, a house for sale is a “red flag” indicator for fraud to insurers. So I would not even volunteer that information , unless asked.

  256. March 21st, 2010 at 12:55 pm #TRB

    Where would I find a good definition that would stand up legally in CA for
    what it means for an insurer to pay for “reasonable repairs to put it back to pre-loss condition?”

    And can an insurer be held responsible to pay for depreciated property value of a residence thats directly related to a covered loss if it cannot be returned to a pre-loss condition?

    Background info: The loss was a foundation crack in a residential house that Allstate Insurance is covering. I have had several experts in their own fields (engineers and real estate agents) state that returning a cracked slab back to a condition of wholeness (uncracked and capable of carrying the same bearing weight of the building as it did previously) is virtually impossible and the real estate side has said that since this has to be disclosed in a real estate transaction the property value will be depreciated on average 20% even if the crack is repaired by epoxy methods or other as most don’t offer more than a 1 year warranty.

  257. March 21st, 2010 at 4:17 pm #admin

    TRB,

    1. I don’t know of any case law off hand, but that doesn’t mean there is not any. You could hire attorney David Parisi in the Los Angeles area to search it for you. Or try any attorney or paralegal. Its just a matter of time to search for it. You could go to findlaw.com and search some of those search terms.

    IMO, if you have RCV, you are entitled to exactly what you had, not some repair or some aduster’s “industry standard” argument. “The construction industry” and “the city building code” is not part of your insurance policy contract. If an insurer has to pay for the cost to put a 1921 house exactly back the way it was, whats the difference with a cracked slab? Does your policy say it will repair your house according to “industry standards”? Does it say “reasonable” repairs?

    2. Now the insurer can take depreciation if you don’t do the repairs, so that’s to their benefit. So if they pay to put back true 2×4 framing lumber and you go back with 1.5×3.75 lumber, they get to take some depreciation that you cannot recover with the RCV policy.

    3. And TRB, you already have experts on your side, and, the burden of disproof is on the insurer, not you, if you have an “all risk” policy (a “special form” policy like a DP3 or HO3, a policy that says “we cover all structure losses except …”). You don’t need to find any case law. Let them find the case law to support their side. And I doubt they will find any. And be sure to read every case they quote, because there are plenty of “insurance whore attorneys” who will misquote and misrepresent case law, hoping no one ever checks on them.

  258. March 26th, 2010 at 6:09 pm #Patient

    Hi,

    Recently I have had a burglarly / vandalisim. The adjuster has disbursed a check for dwelling repairs. The loss of property,after sworn statement and police report,itemized list and receipts avaliable. I also supplied bank statements. The claims adjuster called today to inform me that she will only pay out items I have receipts for. She stated the bank statements do not specify the product just the name and date of purchase. The check will be mailed out today.

    My policy covers full replacement, how can they pay for items only with proof of purchase or manuals. Do I cash check or return and dispute.
    Receipts are now a policy requiremen ?
    If I don’t have receipts for gifts. Clearly this a bad faith claim.

    Sincerly confused.

  259. March 28th, 2010 at 9:01 pm #admin

    Patient,

    Well unless your policy says you won’t get paid on contents you don’t have receipts on, then your insurer cannot deny your claim. Yes, bad faith. I have never seen such a policy, but there is always a first. Now if you have receipts and refuse to give them, then they can deny the item. And no, you don’t have to go back to stores and gather receipts, let their investigator do that. If you can’t afford a lawyer or public adjuster, consider the eBooks at UClaim.com.

  260. March 29th, 2010 at 4:49 am #f. michael conte,CPIA

    You must let the readers know who this carrier is.. that being said, i beleive this is a hard lined position on the other hand i have not seen the list of items. typiclly i would ask for receipts when i thought a claim was being inflated. look for photos that may have the affected items included. look through credit card statements etc. or order copies from your carrier i believethe cost if any is reimbursable.
    fmc

  261. March 29th, 2010 at 10:24 am #Robin Varghese

    I had Travelers of Massachusetts for my insurance carrier when I had a fire at my home. After 2 years of fighting with them I have asked for mediation and they have denied my request insisting that I am beyond the two year statue of limitation. I was told that I had 2 years to submit a claim, is it also true that after that time I cannot request arbitration? Also, the adjuster will not provide his supervisors name or contact information.

    Help, please.
    Robin.

  262. March 30th, 2010 at 2:03 am #wondering what to do

    I recently filed a hail damage claim my residence, then sold the residence two weeks later. didnt think anything of it until i recieved a two party check from travelers insurance to me and the bank. i figured why not try and cash it. It just so happens the bank i had the mortgage through also financed the new buyer, so they say they still have an interest in the property even though i dont own it anymore and are undecided on whether to cash it for me without it being repaired. they requested the adjustors report, I dont think this is a good idea. i think i have a worthless check on my hands, and a wasted claim. wondering if the bank is legally bound to cash it or should i just cancel the claim send back the check. could this be considered fraud.

  263. March 30th, 2010 at 7:30 pm #F MICHAEL CONTE

    dear wondering what to do,
    what were the terms of the sale did yo make a concession for the unrepaired damage? or did yo promise to pay for the repair.
    please advise.
    fmc

  264. March 30th, 2010 at 7:36 pm #admin

    Robin,

    Well, regardless of what your policy says, it is over ridden by state law, the statute of limitations you need to find out is the time to sue them for property damage in your state. Call your small claims court clerk. In most states it’s 3 or 4 years on property damage and 1 or 2 years on bodily injury. How to use this information to get results is in the UClaim.com eBook mentioned below.

    Just the terminology you use and the way you write your question and tells me you are totally being outsmarted by your adjuster. “Mediation” is used in litigation. It’s not in your homeowners policy. If you meant “appraisal”, that clause will not help with “coverage” issues, only valuation issues.

    If your claim has been open this long, and you can’t afford a public adjuster and or attorney, start with the eBook at UClaim on homeowner claims.

  265. March 30th, 2010 at 7:44 pm #admin

    Wondering,

    If you sold the house “as is”, and the buyer was aware of the hail damage, and not expecting the roof to be repaired, or, if the buyer made their inspection after the hail damage date, I would say the money should be yours, as long as the amount of the mortgage was less than the value of the house minus the cost of hail damage repair. Just my opinion. You can check with an attorney and have him send a “shake em up” letter to your mortgagee to sign that check and send it to you!

  266. March 30th, 2010 at 10:59 pm #wondering what to do

    continuing from the previous issue, the roof inspection was done before the hail storm, buyer was not aware of hail damage or claim. i should never had made the claim, however do you think it would effect my future premium price if i was to give the check back to travelers and show it as filed unpaid, and in your opinion what could the consequences be for getting the check cashed.

  267. April 4th, 2010 at 11:16 am #Ali

    Hi,

    I filed a fire insurance claim (partial burn from wildfires and smoke / firefighter entry damage) a year ago and after 3 adjusters I finally agreed on the scope of repairs. Since the repairs have been going on several other other items have come to our attention and been replaced. Will these items be covered if presented with the receipts.

    My claims rep at Farmers Insurance has assigned a local contractor who will contact me for the building portion of the claim we have noticed, mainly exterior brick damage and concrete damage. Is it a good idea to have my own estimates ready when he arrives or just to work with him?

    Lastly, my rep wants receipts for the repairs done at this point for depreciation purposes. I have finished all the repairs and the mortgage company signed off on it. A lot of the repairs were done under my “owner-builder” permit because I also did some mandatory remodeling at the same time. Do I need to show any documents if I am not looking to claim further depreciation except on a few items?

  268. April 4th, 2010 at 9:14 pm #admin

    Wondering,

    Regarding the premium increase, ask your agent. If you cash the check without the buyer being made aware of the damage, after their inspection, you might get sued by the buyer, imo. Check with a lawyer. If you got all the money you asked when selling your house, ethically, why should you get more and the buyer less after the sale?

  269. April 4th, 2010 at 9:35 pm #admin

    Ali,

    If any visitors can answer Ali’s questions in a few paragraphs and keep him out of trouble with his insurer and the law, please do so here.

    Otherwise Ali, if you won’t get a public adjuster and or an attorney, get the eBook at UClaim.com on Homeowners Loss Advice Deluxe for in depth discussions on all your questions.

  270. April 5th, 2010 at 7:43 am #Carmine

    I have the HO 04 77 04 91 “ORDINANCE OR LAW COVERAGE” endorsement on my policy. I have the HO 00 03 04 91 policy as well. What is the limitation on coverage for the HO 04 77 04 91 endosrement?

  271. April 7th, 2010 at 8:50 am #Tom Moser

    A frozen gutter pipe next to my house ruptured during the winter. During a recent spring storm, the same faulty gutter allowed water to accumulate in a flower bed adjacent to my house. The flower bed filled with water and resulted in some water in my basement (enough to moisten the carpet). We have never had a water problem in our basement before. The faulty gutter obviously caused the problem. Should the $2600 carpet replacement be covered by my home owner’s policy in NJ.

  272. April 7th, 2010 at 6:37 pm #admin

    Carmine,

    It should say in the endorsement and your declarations page.

  273. April 7th, 2010 at 6:48 pm #admin

    Tom,

    Well if you have a “quality insurer”, they may agree that the cause was a broken plumbing device and the water was not from the thawed ice. But it’s a stretch.

  274. April 18th, 2010 at 4:08 pm #Reqestor

    After the insurance company approved my claim, the mortgage company sent a draw check TO THE CONTRACTOR made payable to both he and I. He gave me the check but now he wants to deposit it into his account. I don’t trust him to deposit and use the monies properly and/or do the work in a timely fashion.
    Should my bank allow me to deposit the money into my account and pay him as he does the work. And why would the mortgage company take a risk by sending him the check instead of me.

  275. April 20th, 2010 at 10:47 pm #admin

    Requestor,

    Don’t give him over 1,000.00 to get started. You can give him incremental payments, usually in thirds, “after” each third of the work is completed. It does not matter who your mortgagee sends the partial payment checks to as long as it has both your names on it. Just don’t sign the checks until that portion of the work is done. Get a free brochure from your state contractors license board to see how to manage a contractor.

  276. April 23rd, 2010 at 3:35 pm #James

    Hello again! Thank you for your response to my orig post #114 in June, 09. Fast forward; I finally received the check for my claim from my former ins company approx 14 months after the fire. Since I posted in June, because of this debacle, my home (of 21 years) went into foreclosure, and I am basically homeless, living day-to-day with whomever will help me. Re final payment; although I no longer own the property, (thanks in great part to ins. company) and the insurance company knows this, of course the check is made out to former mtg. company & myself. This was final payment for “applicable depreciation balance” which was held back by ins. company. I contacted my former mtg. company regarding this check and basically asked if they would sign off on the check. They said that I should bring them the check and they would give me $1,000 if I would sign off on it!!! (The check is near $8k) Huh? They are aware that I could not make my house payments because I paid the contractor out of pocket what was due to him, which was the money that took 14 months to get from the ins. company.
    1. Do I have any recourse with any of this?
    2. Must I even give the check to former mtg. company?
    (At this point, I’m so fed up & insulted, I would rather burn the check than sign off for $1k because the entire amount should me mine!!) Not only am I homeless because of the thieves, thugs & liars that make up my former ins. company, after all this, the mortgage company wants to play like a street gang!
    Thanks in advance.

  277. April 26th, 2010 at 2:35 pm #Donna

    Allstate sent a check made out only to me for hail damage to my roof. If I choose to not repair the roof and use the money for bills, is this legal?

  278. April 26th, 2010 at 3:52 pm #admin

    Donna,

    I would say it is legal, as long as there is no clause in your mortgagee contract that says you have to use all insurance claim money on house repairs. But check with an attorney. Most mortgagees don’t care about small insurance claim payments.

  279. April 26th, 2010 at 4:01 pm #admin

    James,

    Yeah, I sympathize. My 79 year old Dad got suckered by Countrywide into one of those negative adjustable loans and lost the home I grew up in.

    See if you can find a plaintiffs lawyer to take your case and give him that check as security toward his fee, but don’t sign it unless he gets a recovery of at least 16K, with his fee being 50%.

  280. May 2nd, 2010 at 3:34 pm #James

    Thank you, Admin, using check for security was something I had not thought of – awesome advice. I do wish I would have known of your site, and bought your literature b-4 making a claim with the thugs at my ins. company. When it comes to dealing with such outlaws & wanna-be street gangs, anyone/everyone should BEWARE!! Insurance companies are not your friend. If one does not think like a thug, if one does not have experience being a thug, they will just be easy prey and more than likely end up as I did, road kill. Thank you for this site, and for all you do.

  281. May 4th, 2010 at 4:37 pm #Barrie Elliott

    AAA has “guaranteed replacement” on my house, but my Dwelling Coverage seems low (@ $149 per square foot). I got a quote from Farmers who says my replacement cost is around $180/sq ft, but they only offer a 25% extension on the coverage limit. Should I stick with the AAA guaranteed replacement? The Farmers Agent says I better double check with AAA if there is anything that could VOID my “guarantee” …. (like not keeping the house insured 100% to estimated replacment costs) …. or (like not upping my limits when I put a new floor in or re-do my kitchen counter tops).

    If my AAA “guarantee” was voided, I know they’re not insuring me for enough with just the limit shown on the policy. Is this a worry?

    Thanks.

    Barrie

  282. May 4th, 2010 at 9:53 pm #admin

    Barrie,

    Just fax the AAA agent a letter stating you think they undervalued your house and see if they up the value (and the premium). If they ignore the letter, at least you have something to hold them to if they try to penalize you for being under insured. Most policies have a “coinsurance clause” that say you have to be insured 80% to value, or you get penalized if you have a claim.

  283. May 6th, 2010 at 3:52 pm #Jason

    Hi, I had water overflow from gutters at a storage unit in which I had my personal property stored. This damaged much of my personal property because it was not discovered until I removed the contents. The insurance company agrees with me entirely about how the damage happened and they even agree with the amount of damage that occurred. Everything is good except they have denied coverage based on their impression that there is not a covered peril. I have sent them letters expressing that the coverage is available from the policy that reads, “accidental discharge or overflow from within a plumbing … system”. I assert that the gutters and down spouts are a plumbing system. And if there is any ambiguity in what a plumbing system is, then it should be decided in favor of the insured. They relied on the definition of the word “plumbing” only, and said it refers to pipes, apparatus, etc to distribute water inside a building. Emphasis on “in a building”. I think there is a term that indicates they can’t just take a word and put a definition on it and then put the definition in place of the word and use it. I think this is called noscitur a scoiis. I cannot find a definition of, “plumbing system”.

    I’ve pleaded with the insurance company that pipes, apparatus, etc can be found underneath a home (and not in a building) if the home is built on a slab. I also indicated that a water supply well is many times contained in the ground away from the building and connected to the home only by electrical wires and pipes. Then, I also brought up the fact that a home’s sprinkler system is almost entirely not “inside a building”. In each of these scenarios, the insurance company provides coverage for these items if they should be damaged under the physical damage part of the homeowner policy.

    I also found a case which was ruled by a court to be covered and affirmed by appeal that there should be coverage for the damage in NY, Potoff v. Chubb Indem. Ins. Co, 2009 NY Slip Op 01833.

    The personal property is covered on a named perils basis under an older version of a fairly simple policy. Newer versions of the homeowner’s policy have wording in it that are written that provides coverage for water that overflows from the same items but it namely indicates that overflow from a gutter, down spout, etc is not a covered cause of loss.

    I have sued this insurance company and would like to make a motion for summary judgment but would like to go in with more support that this coverage should be a matter of law based on the wording, or lack of wording, in the policy. Also, this loss occurred in WI and the above Chubb case is in NY. Do you have any advice you can provide? Thanks.

  284. May 6th, 2010 at 5:12 pm #admin

    Anyone want to answer Jason’s long question?

  285. May 6th, 2010 at 8:35 pm #Suds

    In Texas a total Loss due to fire requires the Coverage A policy limits to be paid in full as liquidated damages. What about a rider that increases Coverage A by 20%? Does this fall under the same total loss interpretaion? Example: Coverage A is for $300,000 with a Rider that increases coverage by 20% ($60,000), the insurance company has agreed the home is a Total Loss and policy limits will be paid($300,0000) but is going through an itemized estimate to determine how much of the $60,000 should be paid. Is this correct claims practice?

  286. May 7th, 2010 at 8:03 am #Jason

    I don’t want to be a nuisance to anybody so I will update what I have done. I drafted a summary judgment and addressed the 1. appellate ruling above, 2. that gutters, downspouts, etc are classified as a topic within the Universal Plumbing Code (edition 6) and are therefore part of the “plumbing family”. 3. and I made reference to a newer version of a homeowner’s policy that specifically addresses gutters and downspouts by defining “that a plumbing system … does not include … a roof drain, gutter, or downspout or similar fixtures or equipment.” This is the first time I’ve done this and I want it to work so I’m hoping for some good input. Again, thanks.

  287. May 13th, 2010 at 12:58 pm #Orly

    Thanks in advance for all the advice. We have our house listed for sale. On april 5th we had some hail damage on the siding of the house and we had a claim that is now approved and the check has been send to the mortgage company for endorsement. On april 29 we got a buyer and signed a contract, an inspection was performed on may 7th. and we have agreed on minor repairs to be done, nothing to do with the siding. The mortgage company told us that they will hold the check until repairs are done because it is over $10,000. we don’t want to do any repairs because the house is already sold and we lower the price counting on this money being paid to us. I beleive that since an inspection was done and the mortgage company will be paid in full once the sale takes place, we are entitle to the money. Please advice. Thanks.

  288. May 16th, 2010 at 5:24 pm #Matt

    Hi. A month ago our townhome flooded because the hose from the wall to the ice maker in the fridge split in the middle of the night and ran about 5 hours of water into the kitchen, dining room, bathroom and entry way. I called my insurance company and they called ServiceMaster who dried everything out, ripped all the floors out, etc to the tune of $3,700. We come to realize my HOA’s bylaws state that their insurance policy supercedes mine.

    Now, the new insurance company’s balking on the $3,700 ServiceMaster bill. I signed a piece of paper the morning this all happened with ServiceMaster authorizing the work and it says that my insurance co. will pay them directly. But my name is on the bill, and my insurance co. says they can’t pay the bill because they are not primary, and that the HOA’s insurance co. should.

    What is correct?

    I am also trying to stop the HOA from paying that ServiceMaster bill from the $7,500 that their insurance co. sent them to restore my place. That budget is supposed to be for restoration but ServiceMaster is trying to convince them to pay it for their services, which I believe should be separate.

    Thanks for any help.

  289. May 18th, 2010 at 10:19 am #admin

    Orly,

    Easiest thing to do is wait until the mortgage company is paid off. Then they have to sign the check and send it to you.

  290. May 18th, 2010 at 2:41 pm #Jason

    Matt,
    I’m not admin but your situation seems to be rather simple. If your policy contains language that says your policy is secondary to any other collectible insurance, the other insurance (HOA) will pay first. Your insurance company can pay for it and then get reimbursed by the HOA insurance. These insurance companies can figure out the accounting later after you are back to normal. The main priority should be your as the policyholder and you should not be in the middle of these minor details.

    Since your insurance company is closest to this loss with you and they were involved from the very beginning, they should pay your claim and let you get on with your life.

    The next thing your insurance company will do is send a request to your HOA insurance company to reimburse your insurance company for the damage because your HOA insurance is primary. It’s all a matter of contract language and it sounds like who ever started addressing and paying the claim with you should handle it through completion. (This reimbursement stuff is not something that a policyholder usually deals with because the insurance companies do it behind the scenes to make sure the right company has paid for their responsibility in the end.)

  291. May 18th, 2010 at 2:49 pm #Jason

    Admin,
    I hope it was ok to address Matt’s situation.

    An update on my situation with water damage to my property from water that ran out of gutters and down spouts…. I filed a summary judgment motion supporting the facts why a gutter and down spout is part of a plumbing system. (If the damaging water came from a plumbing system, my policy will pay for the damage). I supported with the NY ruling that determined that gutters and down spouts are part of a plumbing system, I provided the respective chapters, tables, and diagrams from Universal Plumbing Code, International Plumbing Code, and National Standard Plumbing Code that explain the codes and requirements for dealing with storm water drainage on roofs, and a few other side notes of support that it is in fact a plumbing system.

  292. May 22nd, 2010 at 8:17 am #admin

    Jason,

    Thanks for your input. Most valuable!

  293. May 25th, 2010 at 3:26 pm #Veronica

    Had hail damage – adjuster saw barely visible dents in garage door (which functions fine) gave me $3000 towards new door, hardware and paint job. If I choose not to do this do I need to return the money? I will definately be doing the roof and siding issues.

    I’m not looking to rip them off or anything but feel like OK I had this damage you compensated me for it (which is why I pay home ins) but on this particular item I choose not to do it but to put the $ into my home in another fashion. Is that legal? The check was made to me and mortgage company and they signed it and it is now waiting to clear in my account.

    Also if I don’t do it does it hinder any future repairs to garage door if something should happen?

  294. May 26th, 2010 at 1:37 pm #Angela B.

    Can State Farm deny reimbursement on the peronal item that was the cause of a fire? In my case, my Clothes Dryer started a fire and caused approx. 40k in damage. Everything up to this point has been ok except they denied my reimbursement for the value of the Clothes Dryer. I live in PA and would like to know if this is correct, there is nothing in my policy stating this exclusion.

  295. May 27th, 2010 at 11:35 pm #admin

    Veronica,

    Well, unless your mortgagee will sign off on the check without you doing the repairs, then you may have to do the repairs. Without repairs, any future claim payment will just deduct more for depreciation.

  296. May 28th, 2010 at 11:03 am #Jason

    Angela,
    I am not admin but I will attempt to answer your question. You are correct that there is not anything in your policy that indicates your clothes dryer should be excluded from reimbursement since it was the cause of the fire.

    There are basically two approaches that insurance companies apply to this type of situation. The first it that the insurance company will exclude the reimbursement for the item that caused the fire. The premise for this is not very well understood but I will try to explain it.

    The clothes dryer in your case failed to function without causing damage, and set in motion the reason that your other property was damaged. The clothes dryer was essentially not “worth anything” at the moment of it’s failure to function safely. I know it doesn’t really make sense but this is the thought (or thoughtlessness) that goes into these decisions.

    The second approach is that the insurance company will exclude the specific and isolated part of the clothes dryer that failed to function safely and caused the resulting fire. In this approach, the specific part item is excluded as covered and the rest of the entire dryer will be reimbursed.

    In both examples, the item (either the entire clothes dryer or the specific part of the clothes dryer) are not allowed for reimbursement. The insurance company has to follow their procedures so they follow correct (or established) claim settlement practices.

    Obviously, just excluding the specific part of the clothes dryer will yield the most favorable outcome for you. The practice to exclude coverage for the item that caused the fire is entrenched in the insurance industry.

    The best approach it probably to agree that the part that caused the fire should be excluded (hopefully the part and not the entire clothes dryer). If the specific item that failed and caused the fire is unknown, nothing should be excluded from reimbursement.

    I suggest that you politely ask for specifics why the insurance company is refusing reimbursement.

  297. May 28th, 2010 at 11:19 am #Jason

    Veronica,
    I am not admin but will supplement the answer provided by admin. Your specific question was, “Is it legal to spend the insurance money on different parts of your home that was paid for the slight visual damage to your garage door?”

    Since your mortgage company endorsed this check and you have deposited the check, you can use the money for anything you wish. (including going to Vegas and spending it on the blackjack tables).

    Your suggested use of the funds to invest in different parts of your house is perfectly legal and justified. This benefits both your and your mortgage holder by increasing the value of your home.

    There is really no reason to replace a garage door that functions properly and has only minor blemishes.

    Now, please keep in mind that if your garage door is damaged again and you have not replaced it, the insurance company is justified to deduct the amount they have already paid you for the door.

  298. May 31st, 2010 at 6:48 am #Mr. Smith

    Back in Sept. 09 I had a fire at my home witch is still being investigated. I was staying in temporary housing paid by my insurance company (farmers) until one of their investigators popped up at the house and checked my mail box. Since then I’ve have been staying at hotels during the week. My question is I also own another house, which I also reside at on the weekends. Can I still submit my hotel receipts even though technically I have a place to stay if I chose?

  299. May 31st, 2010 at 1:26 pm #admin

    Mr. Smith,

    IMO, yes you can.

  300. May 31st, 2010 at 7:06 pm #Mr. Smith

    Thanks for the quick responce but is it possible you can tell me why you feel it’s ok the submit my hotel receipts?

  301. June 1st, 2010 at 12:36 pm #Angela B.

    My home is being partially renovated due to a fire, instead of staying at a hotel, one of my relatives offered me room/board for $100 a week. I took him up on the offer since this is much less money than staying in a hotel and much more comfortable. So, I submitted the receipts for the first 6 wks and my adjuster contacted me to say he can only reimburse me the cost incurred by my relative for the extra utilities. He stated unless she is running a Boarding house and has a tax id#, she cannot rent me a room?? I live in PA and have State Farm homeowners coverage. Can State Farm refuse this claim because the room is a private home vs a public hotel? Should I start staying in a hotel for the duration or should I force the issue?

  302. June 2nd, 2010 at 10:35 pm #admin

    Mr. Smith,

    1. I’m sure your Farmers policy probably says it pays “incurred” ALE expenses.

    2. I doubt there is a policy condition in your Farmers policy that you have to stay in other residences you own if you have a fire.

    Now if you want to know how to properly and “legally” pocket that ALE money, get the details in the Homeowners Loss Claim Advice eBook at UClaim.com.

  303. June 2nd, 2010 at 10:40 pm #admin

    Jason,

    Thank you so much for your participation. We hope you will continue to contribute your time and expertise!

  304. June 2nd, 2010 at 10:42 pm #admin

    Angela,

    They are jacking you around. See our advice to Mr. Smith above.

  305. June 4th, 2010 at 1:24 pm #BOBBI

    I have a public adjuster working on my home owners claim for damage to my roof. My question is, am I able to repair the roof before the claim is settled? or must I wait for the claim money?. It is hurricane season and I am unprotected at this point…

  306. June 5th, 2010 at 12:41 am #admin

    Bobbi,

    As long as you and or your public adjuster have documented the damage, you should be ok to proceed. But consult with your PA and make sure you don’t create more headache for yourself if you are doing the repairs for less than you think the claim will settle for.

  307. June 6th, 2010 at 1:00 am #jen

    We filed a claim for burst pipe in slab in march. The adjuster came out three times to remeasure. The insurance sent out a check based on wrong measurments. we sent an estimate and the insurance wants to send the adjuster out again. He is not licensed in Calif. what can we do? It’s been three months. Never had water damage clean up either.

  308. June 8th, 2010 at 11:35 pm #admin

    Jen,

    If not licensed, file a complaint with the Calif. Dept of Insurance. And get your own estimate and fax it to the ceo of the insurer. Make a pest of yourself.

  309. June 9th, 2010 at 12:07 am #Jen

    Thanks! We did fax an independent estimate. Now they insist that the same adjuster and the contractor hash out the charges in the estimate. I have never heard that before. We are the insured. Since when does the insurance company haggle with the contractor at the insured’s home, as they are suggesting? As far as the adjuster being unlicensed, the insurance company stated that as long as the co. he works for is licensed – it’s no problem. Is that true? Does this reach the level of bad faith?

    Jen

  310. June 9th, 2010 at 6:37 pm #Jason

    Jen,
    The contractor and the adjuster should be able to work out the charges in the estimate. Sometimes there is some disagreement but that should not affect you at all. This is not something they should do in your presence, but perhaps by the phone when they are at their respective offices.

    The insurance company isn’t in the business of making sure that contractors are licensed but usually contractors, or the company they work for, will be licensed.

    It would take a significant act or lack of action to amount to bad faith. With almost no doubt, this does not amount to bad faith. The level to reach bad faith is rarely reached by anybody.

  311. June 17th, 2010 at 7:56 am #Jason

    g.l.,

    If you are too busy with family responsibilities and other commitments, it would be wise to seek help especially since most of your documentation for your property has been destroyed.

    Regardless of the 10% or 20%, you should choose based on who will do a better job for you and maximize the amount you receive from your claim. I am not familiar with either company or person. What will this person do that you hire? They can’t make your list because they don’t know the items as intimately as you do.

    Make your list and submit the most information that you can that supports your claim. If the documentation burned, it would be difficult and costly to reproduce that information. Do your best.

    You should be as detailed as you can. For example, if you indicate 4 large boxes of maternity clothes, that may not be specific enough. “Large” is not very specific. Were the large boxes tightly packed or loosely packed? Are these maternity clothes off-brand or high-end brand items? Those details are important for anybody to determine it’s value and how it should be settled. Also, it is important to provide the approximate age of all the items.

    You ask: “Does the insurance under circumstances pay a % of the policy value without all this detailed work?” This probably would be the appropriate method of settlement for your claim but it depends on your adjuster.

    As far as the suits and the stored items, you simply have to list the items to the best of your ability and make the claim. Every claim is different but the majority of families have certain items and clothing depending on their lifestyle. Pre-purchasing gifts is a common practice for some families so it would be appropriate to claim those gifts. Some policies exclude obsolete or stored items so you would have to review your policy for that. Sometimes the only proof you can provide is a list so make it as detailed as you can.

    Yes, possibly showing your lifestyle can be part of your claim proof. Families who have a wealthy lifestyle will have different possessions than blue collar working families. The clothing’s depreciation will generally be based on when it was purchased, not based on the time it was used. Maybe the people who packed would assist your claim but may not benefit you as much as the hassle of gathering that information.

    Simply provide as detailed a list as you can. The largest U-Haul cannot contain more contents than it can physically contain, no matter how good it is packed.

    It is difficult for you to make an accurate claim without expense and replacement receipts. Regardless if you kept receipts, they are valuable to support your claim. The best thing in your case is if you get an understanding adjuster that is settling your claim. Whether your were told to save receipts, saving receipts is an understood course of action when you expect to be reimbursed. Would an employer reimburse your business expenses without receipts?

    You should attempt to complete your claim as soon as possible. You will have 1 year from the date of loss to make claims for replacement items. If you don’t get the list in before a year, the insurance company may not have to contractually honor your claim.

  312. June 17th, 2010 at 1:26 pm #Kelly

    g.l.

    I am not in the insurance business but I do home inventories for people and have been enlightened by many insurance agents. These are the things that you might look out for. Replacement cost usually means they will give you depreciated costs until you provide proof the items have been replaced. Make a detailed list by imagining each room, then each wall of the house (spread sheet will work best). The insurance company will pay you as you’re list grows as you will constantly keep remembering items for the next year so you will receive numerous checks. The insurance company may give you two years. Do not sign off that your list is finalized till the end of the time frame they give you because you will remember items after that. Everything from your dresser down to your shampoo bottles can be listed.

    I have heard that if you are wealthy and can substantiate it, they may just cut you a check for the full amount but that’s usually a company like Chubb that insures the wealthy (over $1 million homes).

    Good luck and at a bare minimum, video tape the contents of your home including inside closets, drawers and cabinets at least every two years and send a copy to grandma’s house for storage.

  313. June 22nd, 2010 at 6:49 am #f. michael conte,CPIA

    kelly,
    good advice except for the chubb comment. Chubb is a quality carrier that insures those who apply for coverage, there is no “wealthy” requirment.
    most people only care about who they are insured with at the time of claim. Many people only buy the ceapest policy they can, these are usually the ones that end up with claim trouble.
    i have represented chubb for many years, each year i get calls from people who say “i want chubb” when i ask why they say because my neighbor had a claim with them and they did the right thing!
    can you imagine doing the right thing and selling more insurance…..wow how simple!

  314. July 4th, 2010 at 2:41 pm #margie

    neighbors tree fell in my inground liner pool. insurance company took 8 days to send out sub contractor who looked at other property damages, but only collected my outside estimate for re-doing pool and would send to insure company. going on 12 days from original damage to pool,still have not heard anything. insure company is not local. how do i go about getting pool back to original state if i have no word from insurance company. What are my rights? I want to get back to living life like before damages. THANKS

  315. July 5th, 2010 at 9:52 pm #Jason

    Margie,
    Call your insurance company and talk to your claim handler. The insurance company pays for the damage of covered property less your deductible. It doesn’t matter if this tree belonged to your neighbor or if it was your tree. You will need to find someone competent to actually do the repairs but if you want cash in hand prior to doing the repairs, simply communicate with your insurance company.

  316. July 6th, 2010 at 8:16 pm #suzanne

    We have an insurance claim in progress due to water damage in the master bath (Shower, dry wall outside of shower…not flooring). The contractor can not find the matching tile. The insurance adjuster is saying we have to pick out something close to match the floor and will not replace the floor. Is this acceptable, allowable. The shower, shower step, outside shower wall, and flooring all touch starting with the shower and working its way outward…Our policy does not say it covers or will not cover matching replacements. Thank you for your help. Suzanne

  317. July 7th, 2010 at 7:50 pm #Tim

    Hi,

    I have a major problem. I was having my roof replaced, and after roofer did tear-off, I found that I need new roof decking as well. My insurer is refusing to pay for decking, and I can’t afford it either.

    I was planning on doing a short sale after roof was completed as my income is only a third of what I was making before. Now I have a roof covered in felt that has partially blown off twice already, and has caused some flooding damage in my house. What steps should I take? I believe my roofing company is somewhat negligent for not protecting home from water damage during job, but understand they can’t endanger themselves working up there on bad decking.

    Please help, any advice is appreciated.

  318. July 8th, 2010 at 6:08 am #Jason

    Tim,
    It is correct that your insurer will not pay for roof decking. This does create a bind for you because as a homeowner you are responsible for the maintenance and upkeep on your house.

    From the circumstances you provided, it appears the roofing company is doing what they can given the circumstances. They cannot proceed unless you pay for the decking work.

    If there is interior damage, you can make a claim for that but I don’t think the roofing company is negligent for a job that has stalled because of the homeowner’s lack of funds to pay for the project to continue.

    Also, with a short sale, that is basically a voluntary foreclosure and if there is not a roof on the house, bad decking, and water entering the home, the amount your bank will receive from a sale is lower than it otherwise would be. You may want to talk to you bank about your situation to see if they want to become involved. But don’t get your hopes up.

  319. July 8th, 2010 at 6:22 am #Jason

    Suzanne,
    The insurance company owes for direct damage and if the floor isn’t damaged, then the floor is not something that will be paid. The mentality of any job is that wall tile, step tile, and floor tile are all separate items that make your claim one that will be difficult because of the lack of matching tiles. The insurance adjuster is doing what is both allowable and acceptable in this circumstance.

    Try to be creative and either accept that you have to pick a similar matching tile, change the tile that is being replaced with a complementing tile to the floor tile, or contact the insurance adjuster’s manager by phone, letter, or both to express your concerns.

    You are correct about your policy not addressing matching but the policy does indicate it covers “direct physical damage” and if your floor is not damaged, they will only consider what is damaged.

  320. July 9th, 2010 at 9:31 am #Mr. Smith

    What happens once an insurance company denies your claim? Are you responsible for any funds that they paid on your behalf? I.E. Living expenses?

  321. July 9th, 2010 at 2:16 pm #Jason

    Mr. Smith,
    That is a very good question. If it is a matter of the insurance company paying for living expenses and lodging from a fire that was being investigated which may be one of the primary reasons for payments being advanced before a coverage determination is made, then it may depend.

    It may depend upon their finding of arson, for example. If that is the case, then they may ask that money is repaid.

    However, if their conclusion is that the premium was not paid on time, and coverage is denied because coverage lapsed, then they probably would not ask that money is repaid.

    For both examples, the insurance company probably won’t ask the money to be repaid or initiate suit to recover the money they advanced especially if the amount advanced is a small sum.

  322. July 16th, 2010 at 4:17 pm #Andi

    Our finished basement was destroyed by water due to some very wet weather this spring. We received a nice settlement. We suspect that the adjuster was very sympathetic, as we had just moved into the house and there was a lot of damage. He even “threw in” a wind damage claim to help cover some of the expenses since we had maxed out the water damage claim. We saw this as an opportunity to really maximize the basement’s potential, since it appeared that no one had given it a thought since the 70’s. We hired a great contractor to replace the damaged walls, tile the bathroom and patch the fence (wind damage claim) and we bought new carpet from Lowe’s. I am painting myself. I’ve had our contractor who is also a plumber and electrician do other little things for us in the basement, like install shelving, help fix electrical issues, etc., but we’re still coming in under the claim amount. The house needs a lot of work. Would it be appropriate for us to use the remainder to retile our kitchen floor (which is a disaster) or replace our front and back doors? (The adjuster’s report included replacement doors for the basement. They turned out to be fine. So could these be “the doors”?) We also have another bathroom with major issues that really needs to be overhauled. Our mortgage is with CitiMortgage. They seemed to indicate to me a while back that they didn’t really care what we did with the money as long as it went into fixing the basement and enhancing the property in some way. Is this the case? If not, what will happen to the remainder of the money? It would be such a shame to lose it.

  323. July 18th, 2010 at 1:29 pm #Jason

    Andi,
    This is the way claims should be settled so people can fix what is damaged without skimping along the way. If your mortgage holder is flexible in what you are doing, then you should be fine with your plans to fix and update other parts of your house. The insurance company accepts that your damage was outlined in the estimate by the adjuster and that is what your claim is based upon. There is nothing preventing you from fixing your damages for less than the amount allowed because you appear to have hired workers in an economical way and you are even doing some of your own painting so there is nothing inappropriate for you to be compensated for your time and labor. Good luck with the updates.

  324. July 18th, 2010 at 1:59 pm #kara

    Hello,

    Could you tell me if it is standard procedure for an insurance company to do a background investigation after a total loss fire? Also, what do they look for? We do not have any kind of criminal history whatsoever, but we do have negative credit. How does a negative credit history affect the claim?

    Our home was a total loss…burned so badly that the fire chief, fire investigator, SBI & even the insurance company’s investigator were not able to determine the cause.

    They did speculate on possible causes and location of where the fire started….none of which pointed to arson. We were also out of town at the time of the fire.

    All investigations (fire dept., investigator, SBI) have been closed except our insurance company’s.

    Thanks for your time and response.

  325. July 19th, 2010 at 9:30 am #Jason

    Kara,
    Yes, a background investigation is standard procedure if the insurance company believes it is necessary. What do they look for? That would be any type of situation where it would be advantageous for you to burn your house or have someone do it for you. A background check may be vague and involve a review of your criminal record and credit history or may become more involved to include interviews with your neighbors, family, friends, and/or co-workers.

    These interviews by these other people are not required by law or contract but many people provide information freely because they believe it is important. If the investigation does not reveal new avenues to uncover, it should be completed rather quickly.

  326. July 21st, 2010 at 3:23 pm #Public Adjuster

    Jason; referring to Suzanne’s post regarding matching tile.

    I don’t entirely agree with your position. It depends on the policy and the regulations in that particular state. In California (and many other states) for a replacement cost policy the carrier would most definitely owe for the floor tile even if it did not receive direct physical damage. The Fair Claims Settlement Regulations in California basically state that the carrier owes to return the property to a “reasonably uniform” appearance. If the tiles matched before.. they have to match when being replaced.

    Even beyond a Replacement Cost Policy – the policies (excluding named peril/acv) are designed so that when the insured suffers a loss – that their property be returned to the pre-loss or better condition without a constant visual reminder that the loss ever occurred.

    I believe in this situation, unless Suzanne has a Named Peril – ACV policy.. that the carrier owes and is in a bad position.

  327. July 22nd, 2010 at 6:34 pm #Jason

    Public Adjuster,
    Thank you for your input; I appreciate your post. If Suzanne’s policy is the most liberal one available, that is what we have to assume because that practice is followed in many states and not just California.

    If the wording is “reasonably uniform appearance” then that would mean just what is says but this wording isn’t a black and white variable. I do not disagree. I merely indicate that term for the situation she describes could fall into the category of replacing all the tile including the floor or simply replacing the tile of the property that is damaged. If I was adjusting this claim, I would replace it all. The problem is the the position has been made that they believe that the property can be replaced to a reasonable uniform appearance by not replacing the floor (the floor is not damaged).

    The nick-picky position that they seem to be holding is that the tile surround or step is just that, a tile surround and/or step and is not the floor – but simply a tile surround and/or step.

    Although I believe this could and should be settled to the satisfaction of Suzanne because she paid for the coverage, the insurance company is not necessarily in a bad position because it is very difficult to change the perspective of the insurance company unless a judge would indicate that it should be changed. If this is a California claim, perhaps there is a method to dispute the insurance company position short of a legal action.

    An approach that has been used frequently is the “line of sight” perspective and it is based on the principle that at any given moment a slightly different shade of shingle color on a two connecting roof slopes, for example, cannot be distinguished because of angles, light direction, and visual perception differences. It is an approach that can apply to many things.

  328. July 23rd, 2010 at 9:59 am #Public Adjuster

    Jason,

    In CA the “line of sight” doctrine has been tossed out in lieu of the “reasonably uniform” appearance. In Suzanne’s case she states that the wall tile and shower step touch the floor. The insurance company is aware that the contractor cannot get a matching tile so they are demanding that she pick out something similar. Similar is not reasonably uniform. They are asking her to alter the visual appearance of her property under a covered loss just so they can save a few bucks. There are so many factors that weigh against the insurance company in this situation – this is why I stated they are in a bad position. I’m not talking bad in the sense of legal action. I can’t imagine this is something that would ever see the light of legal action. What I mean is that their position has no substance.

    If their position was solid – then they could ahere to this position on all claims that for instance involved 10 square feet of damaged tile in a 3000 square foot house – only replacing the 10 square feet. I have successfully fought these cases time and time again even with 1 broken tile that could not be reasonbly matched. In fact, in a case we are working on right now the carrier actually wants to remove 1 broken floor tile, take a floor tile from under the stove, move it to where the broken tile was, and then replace the one under the stove with a “similar” tile.

    While I agree that is what I might do if I didn’t have insurance and wasn’t filing a claim, the carrier doesn’t have this right. They have the right to repair or replace – but not the right to alter the property.

    My recommendation to Suzanne parallels yours; speak with the supervisor, have the contractor speak with the supervisor, and if that doesn’t work then ask for the claims manager.

  329. July 24th, 2010 at 9:47 am #Jason

    Public Adjuster,
    That is great that we agree on the approach to this matter involving Suzanne. Just like your remedy, I would replace the entire floor as well because I would not want Suzanne calling my supervisor or claim manager. Claims should be “settled” and that means both the insurance company and the customer agree about all the issues rather than forcing it upon someone.

    Now in your comparison with 1 damaged tile or 100 sf of damaged tile, it is likely that tile was all on the floor and that would change the appearance of the floor so I buy into that every day.

    Let me just say this. I understand the adjuster’s position that the wall tile and shower step are not part of the floor and to address what is damaged and what is not. I don’t agree with his position that he should not include the floor as well since it is easier to pay for the floor and close the claim than it is to not pay for the floor and keep the claim open with calls to supervisors and managers.

  330. July 27th, 2010 at 2:58 pm #Celena

    My home was built in the thirties and has a cinder block and brick foundation. Last week, torrential rains caused a “sudden and accidental” build up of water pressure behind the foundation and it blew a six foot wide hole in the foundation.
    The insurance company has denied the claim because it was “water pressure” from the saturated ground and the inadequate foundation wall. How shall we proceed.

  331. July 28th, 2010 at 10:48 am #Public Adjuster

    Celena,

    Set aside the fact of the inadequate foundation because if the foundation served its purpose for 70 years and would have continued serving its purpose for another 70 then the insurance company is just throwing that in there to try to bolster their denial. Generally speaking damage from pressure exerted on a structure by water, tree roots, earth movement etc. is excluded from coverage. However, there may be an extremely remote chance for coverage if there are any other factors that contributed to the loss. The best way I can explain this is by giving an example of another claim that I covered as an adjuster for an insurance company many years ago.

    A homeowner files a claim for exactly what you filed for. The insurance company denies the claim for same reason. I review the claim file and interview the homeowner. During my interview I note they have lived there for 15 years with no problems. I also note that about 100 yards from their home is a fire hydrant that had been damaged. I asked them about this and they stated a car had struck the fire hydrant a few weeks prior. Further investigating this I realize that a channel had been created by the flow of water from the fire hydrant that led right the home. So, when the torrential rains came it allowed the rains to be diverted to the house and cause severe flooding in the home. I overturned the denial and covered the claim.

    So, you need to think if there are any other factors that may have contributed to the loss occurring which set the chain of events in motion which would not otherwise have occurred. Such as, was the city working on the street nearby, was there a recent fire in the area that burned away the vegetation, did a neighbor do construction on their home that caused water to be diverted to your home, were the drains clogged because a tree trimmer cut trees and left the branches in the drain… etc. etc. etc. Like I said, it is REMOTE that your claim will be covered. Very REMOTE. But it’s worth you taking the time to think about other factors.

    If not, then unfortunately we all must realizes that there are exclusions in a policy and not all damages are covered whether or not they are sudden and accidental.

  332. July 28th, 2010 at 6:46 pm #Jason

    I happen to concur with Public Adjuster. Good luck!

  333. July 29th, 2010 at 5:43 am #f. michael conte,CPIA

    to PA

    excellent comments one of the reasons i enjoy reading this blog it is always informative.
    fmc

  334. July 29th, 2010 at 7:53 pm #Jason

    If anyone has any general insurance questions that relate to this site, you are welcome to post your questions and we will certainly provide you with the insight we have. My brother had his sump pump that did not click on during a heavy rainstorm and filled his finished basement. He had no idea it would be covered by his insurance until he talked to me about it and I gave him the insight that in many insurance policies, that coverage is not there unless the additional coverage is provided through “water, sewer, and sump pump overflow. He simply read his policy and found that it was not covered but did not read the additional riders he had on his policy. We reviewed his entire policy and he did indeed have that coverage, limited to $5000 and a $500 deductible. Instead of him dealing with the situation by himself, he was able to get a restoration company to deal with it and he paid his deductible and all was taken care of to his satisfaction.

    The homeowner policy is not an easy read and my brother works in the construction business, not insurance so he had no idea what is in his policy and unless something happens, he really doesn’t care.

  335. August 6th, 2010 at 7:17 am #Ruth

    I have had recent hail damage. There is water damage to the living room and the family. The insurance company is holding back coverage citing “overlapping claims” from 1998 and 2002. I cannot remember the 1998 claim, but am certain that that any work related to the claim was done. I do have receipts for work done, but not all was contract work. I probably can substantiate the work being done (once I receive a copy of the claim that is referred to), however I am wondering if the insurance company can ask for that. There is no reference in the policy of anything of that nature and when I asked the adjustor, he outright said that it was not in the policy, but that the state of ND concurs with their position.

  336. August 6th, 2010 at 3:15 pm #Public Adjuster

    Ruth,

    This should be fairly simple. An insurance company should not be required to pay for damages to an item more than once. I think we can all agree for example that if they paid you to replace your flooring in your living room from a prior loss, and you didn’t do it, and you suffer damage to the same exact flooring again, well… there hasn’t been any additional loss.

    With this being said, if the insurance company is stating that you failed to make repairs from a prior claim, have them pull the file along with the photographs from that file, and prove it. If the damages are exactly the same – for instance… same stains on the ceiling, walls, same flooring.. then there you go… they made a correct decision.

    Carriers were generally working with paper files back in 1998 – so chances are they archived the ’98 file and the adjuster didn’t see those photos. But in 2002 carriers were jumping on board with electronic files and it is a high probability the adjuster could see those photos and reproduce them for you fairly quickly. So ask to see them. If they cannot produce them, and you are reasonably certain you made the repairs, then let the adjuster know that the burden is not on you… it’s on them. Just because you didn’t save receipts for 8 years doesn’t mean you didn’t do the repairs. I think it’s unreasonable to request receipts from 8 – 12 years ago. People suffer damages in the same areas often. Water from a roof often runs to the same or similar low points. But I suspect that the adjuster has the photos and if he/she was diligent in their investigation of the claim would have reviewed those photos.

    Also, look through your own photographs from a year or so ago. You must have photographs of your living room during a birthday party or the holidays or something. Confirm for yourself whether you did the repairs and if so, then show the adjuster.

  337. August 6th, 2010 at 9:05 pm #Jason

    Ruth,
    The insurance company simply does not want to pay for the damage twice. If they paid for the damage in 98, they don’t want to pay for it again if it was not repaired or replaced from the last claim. If the same property was damaged again and they paid for it already, then they have met their contractual obligation, even if there was no need to replace it after the damage from 98 (since damaged property will still function or service it purpose even it was visually damaged or suffered a reduction in it’s serviceable life). If you have the receipts and documentation for the repairs or replacement, you should be fine.

  338. August 11th, 2010 at 6:30 am #Heather

    We had a small flood in a carpeted room. When we pulled back the carpet we discovered damage to the hardwood floor underneath.

    Adjuster says that because the hardwood was covered it is an “abondoned surface” and repair to it is not covered (they will pull it out and put in plywood and carpet).

    Also – there is still a musty smell in the room even though they say it is all dry.

    Any advice?

  339. August 11th, 2010 at 8:33 am #Maggie

    Hello-

    I just experience a water damage due to clog aircondition pipe in my attic. It was an old system that was build in the attic. I am concern now that celling damage are escalating to 7 days drying and removal of small portion of the celling foundation (plank) and plaster. The adjuster did not confirm if the damage is cover or not the damages, at this time they just recommending contractor to look at it and determine the cause of the leak. Which it did – clog pipe and blockage. The adjuster did not came into my house to even look at the damage. Yet, they been nice to accommodate us for hotel stay because of the noise in the house and we are not able to get a decent sleep. Its confusing us –

    Because of the work will take 3 – 6 weeks, would the insurance pay for all the loss wages? I am skeptic allowing people coming and going without us being home. I have so many question – the BIG IF something happen / loss / damage and what else can go wrong. What will be the insurance do / I also have alarm which will be disconnect while people and coming and going. “would I need to let them know?

    Questio:
    1Would clog pipe that cause the water damage are covered benefits?

    2Would the Insurance pay for loss wages – FYI they told me that they will not reimburse me for any loss wages due if I stay home while the house is in
    construction.

    3What should I spect if I use a lock box key. Letting people come and go without us being home. Which I am back to the BIG IF –

  340. August 11th, 2010 at 3:31 pm #Public Adjuster

    Heather,

    That’s a popular tactic by the insurance company to consider the flooring below carpet “abandoned”. I don’t agree with them. The reason is because many times I see people move into houses just like yours, pull up the carpet, and re-sand the wood floors, finish them, and they look fairly nice.

    To put back plywood where there was once wood floor is not the way you had it. What I would agree with is to replace the wood floor where damaged with the same floor.. sand the surface, and seal it. I don’t believe they owe to “refinish” the floors to a perfect condition, but at least put back what you had. Explain to them that doing the repair their way doesn’t put you back the way you were and removes the option from you if you ever wanted to pull up the carpet and refinish it which is a common practice.

  341. August 11th, 2010 at 3:39 pm #Public Adjuster

    Maggie,

    The claim should be covered assuming you have a standard homeowners policy. Most policies cover a sudden and accidental discharge of water from within a plumbing or heating/air conditioning system.

    The insurance company does not owe you for your lost wages. Damages to your home is unfortunate, but it is your home and it is going to take some time and effort on your part. Your homeowners policy is not related to employment/business.

    I assume they have paid you enough to allow you to hire a general contractor. You should hire a very reputable contractor that is willing to complete the work for the amount that the insurance company has paid. Check references, speak to others that have used the company, and so forth. This should cut out the need for you to have to be home while workers are there.. and also ease your mind about having a lock box on the door. All security systems that I am aware of allow you to change the code or even allow multiple codes. Give the contractor a code and he/she should be responsible for opening up and securing the property each day.

  342. August 11th, 2010 at 7:07 pm #F MICHAEL CONTE

    Heather,
    I have never heard of such a thing. insurance contracts are contracts of indemnity, that means they need to put you back into the position you were in prior to the loss. therefore if they take out hard wood and reinstall plywood your are not in the same position and therefore not indemnified.

    Please tell the readers who is doing this to you and what state you are in, also, please read your insurance contract, and i believe you will find wording that says “repair or replace with like kind and quality”. as for the musty smell have you hired a clean up crew or did you do it yourself? if you did not hire a clean up crew perhaps it is not too late. this should also be covered by insurance. and finally please ask you agent to get involved and guide you accordingly, this is why he/she earns a commission (you might need to remind them of that).

    good luck and let me know how you make out.
    f michael conte

  343. August 11th, 2010 at 7:14 pm #Jason

    Heather,
    The hardwood floor is technically the underlayment and the adjuster is correct about that. The top layer of the floor is the one that is being used and apparently the hardwood was abandoned for the carpeting on top.

    If the remedy is to remove the hardwood and carpeting to replace it with a new subfloor and carpeting, that should take care of the issue involving the musty odor.

  344. August 11th, 2010 at 7:24 pm #Jason

    Maggie,
    The situation sounds like it would be covered because it escaped from a plumbing system and air conditioners do have a drain on them for the water that condenses in the unit.

    Insurance is there to pay direct damage. I don’t have a solid understanding of your lost wages but it is very unlikely that lost wages would be considered by any insurance company.

    There is a certain amount of trust you have to have in the contractors that are doing the repairs to your home. If something happens, then that would be another issue you have to deal with. It is very difficult to answer what-if questions because there are so many what-ifs that the answers could go on and on.

    I will address two what-ifs. The first being the contractors doing an inappropriate job or repair and then that would have to be a claim against the contractor since your insurance policy likely excludes faulty work by others. The second would be if a contractor stole some valuables from your house. If that happened, you would be dealing with a theft and that is not a direct action to your water damage so it would be another claim and subject to another deductible.

  345. August 12th, 2010 at 7:50 pm #Jason

    Dear moderator,
    Please note that our answers are very similar in context. Can you please allow the comments to pass through without moderation review because I would not be answering the questions if I can see that others have already posted their answers? Thank you.

  346. August 13th, 2010 at 5:29 am #Maggie

    Thanks – because I will be dealing with 3 different company to fix the damages in the house, I will be making sure that everything I condisered deem important will be lock up and pray for the best.

    Thank for your advice, I do love this site for all insurance muble jumble confusing information, just for the sake of being covered. 🙂

  347. August 13th, 2010 at 6:02 pm #Jason

    Maggie,
    I hope the damages are fixed to your satisfaction. The world of insurance can be a rough world and it seems to be stacked in the favor of the insurance companies at every turn and curve. Information and knowing what they can and can’t do is the best tool to deal with them when the time comes for a claim.

  348. August 14th, 2010 at 12:32 am #admin

    Jason,

    So sorry for the delay. Excellent suggestion regarding pass through of your comments. We hope to be able to do that for you and the other active contributors very soon. Your contribution is most appreciated. 🙂

  349. August 17th, 2010 at 7:11 pm #admin

    Jason,

    Comment pass through is now set up. I think activity may be down the last few days due to “back to school” activities? Thanks for your patience.

  350. August 17th, 2010 at 8:28 pm #Jason

    Admin,
    Thanks for the pass-through on our comments. That will help a lot to prevent duplication because the answers are very similar from a lot of us posting. I really appreciate you having this site available for the people who are having issues and concerns with insurance companies.

  351. August 23rd, 2010 at 1:14 pm #Marti

    My son had an arson charge dropped and was charged with criminal damage (which unintensionally caused a house fire) in a neighbor’s house. We were told that our home owners insurance would pay the claim as long as there was no arson charge. Can they still consider a charge if it was dropped. Before I make a claim, I need to be certain that arson cannot be considered since we could loose our insurance. Thanks for your help.

  352. August 23rd, 2010 at 8:33 pm #Jason

    Marti,
    That is probably a very good question for an attorney to address. You really would need to provide more information for that to be address with any accuracy. The insurance company does not charge arson nor criminal damage. There are no certainties in life when it comes to arson, criminal damage, etc. A claim can be denied for arson though. If arson is proved, that can be a reason to deny a claim but we don’t have enough information about your circumstances and it can be rather complicated. If you lose your insurance, then that may be something out of your control no matter what if it involves arson or something similar.

  353. August 24th, 2010 at 7:16 am #f. michael conte,CPIA

    Marti,
    you need an attorney as stated previously. there is wording in the contract that speaks to criminal acts, my spin is there is never coverage for a crimianl act as it would be against public policy.

  354. August 24th, 2010 at 10:27 am #Marti

    Thanks for your input. Some details I did not state:

    We have State Farm as well as the victim. There was a State Farm lawyer in the restitution hearing for the victim’s damages. We negotiated on an amount. They found out that we owned a home and also had State Farm and we were told by the judge that we could submit a claim and have St. Farm pay it. We decided not to pursue this until we researched further so we told the court that we would decline to submit to our insurance for now. I called my local insurance rep and she put in a call to State Farm to get more details. She told me that because we have been good clients for over 10 yrs., that they would pay the claim without raising our rates provided the charge was criminal damage. They said if the charge was arson then they would still pay the claim but immediately cancel our insurance and we would most likely have a hard time replacing our insurance through another company. Like I mentioned, the arson charge was dropped but it still remains in the records for the attorneys to view. I don’t believe they can legally consider it and can only consider the actual charge of criminal damage. I am currently awaiting a call from my son’s attorney to see what she may know about the legal implications of this.

    Thanks again for your input. It is much appreciated!

  355. August 24th, 2010 at 3:29 pm #Jason

    Marti,
    Thanks for the additional information. It seems that a criminal damage charge (or conviction) requires the “intent” of the person doing the damage. otherwise it would be called “accidental damage” and would not be a crime involving a prosecutor. The insurance contract does not cover criminal acts or intentional acts, just fortuitous and/or accidental acts. Arson is an intentional and criminal act just as criminal damage to property is a criminal act. I don’t understand how criminal damage is unintentional so this one is probably best to be handled by an attorney.

    If you are concerned about losing your insurance coverage, your insurance company, State Farm, already is aware of this situation whether a claim is filed or not so you have to weight the pros and cons of submitting the claim including the amount you have to pay for settling, being reimbursed, or hoping the best happens from the entire situation.

    Something gives me an idea that State Farm will pay regardless if you make your claim or not. If this was intentionally committed by your son, State Farm may seek restitution or subrogation from your son for any amount, if any, State Farm pays for the damage.

  356. August 26th, 2010 at 2:15 pm #Ron

    I am preparing a homeowners claim after being broken into. Any advise on how to get the value of things missing or broken. Before I even made a claim I got a letter from Kemper Insurance saying they may drop me……. sad isn’t it?
    Thanks in advance.

  357. August 26th, 2010 at 6:53 pm #Jason

    Ron,
    The advice about the valuation is make a list of the items stolen or broken and find out the cost of these items new. Then on the same list, determine the age of the items. Everything has a useful life. For example, if you have a television that was stolen and it was 3 years old and cost $500 when new, you would determine its value by subtracting the “used” portion to come up with a value of the television. In this example, a useful life of the television is 8 years so 3 of the 8 years are used up and there was 5 useful years of value left.

    Simply take 5 and divide it by 8 to come up with 62.5% of the television’s value was left ($500 x .625 = $312.50).

    This is a common approach that many adjuster’s and insurance company’s use. Of course, the television you purchased for $500 three years ago may cost $400 today so the valuation would be a little less. Good luck.

  358. August 27th, 2010 at 7:50 pm #Lori

    we recently had a water pipe break due to a frozen pipe in our basement. Before the water main could be shut off, our treadmill, a flat screen monitor, remote controls and other electronics were soaked. They did not sit in water, but the water ran through them. Our adjuster says that as long as they still start up no claim will be made because they still work. Is this right? In our opinion, if we try to sell the equipment, we will need to reveal they have water damage, thereby reducing their value.

  359. August 27th, 2010 at 8:54 pm #Jason

    Lori,
    Keep up your insistence that these items are damaged due to the water incident. If remote controls were in water, that only makes sense that they would be damaged or corroded in some manner. The treadmill’s motor is at least a few inches off the floor and that seems to be the only thing that would be affected on the treadmill. The flat screen monitor, if subject to water, may interfere with it’s performance. It is hard to imagine the flat screen monitor being affected by water since most people have those at an eye level height. Perhaps the water sprayed or was dripping down the wall that the flat screen monitor was mounted. I don’t know the details with the information provided. If you sell the equipment, you don’t have to reveal water damage if they don’t have water damage. Not all things exposed to water will be damaged just by the exposure to water.

    Avenues you have available to you include discussing your concerns with the claim manager of you insurance company or simply having an electronics repair person inspect the items of concern so you are at ease that they are not damaged, or so they can provide their expert opinion that the items were affected and/or damaged by water exposure.

  360. August 28th, 2010 at 11:37 am #F MICHAEL CONTE

    Sorry no claim.
    Who is buying used flat screen tv’s, they are almost giving them away now.
    Be thankful they work and get on with your life.
    Enjoy!

  361. August 29th, 2010 at 8:18 am #josh

    I have extensive water damage in my house. Allstate has sent the remediation service and they have so far taken apart approx. 50% of my house.

    There were personal items that were affected and some are a no-brainer destroyed. Some I am not sure. Specifically, I am concerned about electronics.

    I have a tube tv that had water and dry wall on top of it. The TV may still work (dont know yet). My concern is water is inside, and corrosion could take place a year from now and it wont work then. So is the TV (or stereo, or Wii) covered or will I have to accept it isnt covered if it works now?

  362. August 29th, 2010 at 9:37 am #Jason

    Josh,
    Discuss your concerns about the tv, stereo, and Wii with your adjuster.

  363. September 7th, 2010 at 10:04 am #Maggie

    update – my house is turning out to be a war zone after the water damage. I found that my insurance have a PSP programmed that helped me to elevate all the worries. Through State Farm, if you have home damage – they have PSP programmed that if you hire the water remediant/contractor/flooring/windows all this service and they are participating the insurance program, they help you out with you processing of the work. This give the insurance a guarantee work and contractor will not get paid until the job is done, and the homeowner is satisfied of the job. The payment however will be made direct contract and not to me and the job has a warantee of 5 years after the work is completed. Everything is in detailed and so far I am very satisfied.

  364. September 7th, 2010 at 11:05 am #Public Adjuster

    Maggie,

    “elevate” or “alleviate” all the worries? Based on your last sentence it seems that you are satisfied so I assume you mean “alleviate”.

    I am very familiar with State Farm’s PSP (Preferred Service Provider) program. If it is working out for you then that is great. However, I have run into many situations where things were not so great for insureds and I would never recommend going this route to a client until AFTER the claim has been settled.

    On one particular case through my office a PSP contractor estimated the water damages at approx. $8,500.00. We assessed the loss and settled the case at $183,000.00 with State Farm. I later met the contractor on another claim and asked him how in the world he missed it by so much. His response to me was that he didn’t believe they were going to get the job so he just whipped through his estimate. If they did secure the job then he would just supplement the claim by “discovering” hidden damages.

    I say this because it is important to have your loss properly assessed by a professional and not leave it up to the PSP contractor. There is no reason why you can’t hire the contractor after the fact. If you hire them up front, then in my opinion you are not making an informed choice as a homeowner with all of your options available to you.

    I realize the case I refer to is a little extreme, but this situation arises all the time on some level for a variety of reasons. Especially if a PSP contractor is lowballing so that it essentially forces the insured into using them. Many may not believe something like this would happen.. but it does! And then after you sign and go with them, the PSP contractor is supplementing a claim for much more money then the original quote was. I believe this is unfair to a homeowner because had they known the “full value” of the claim then they may have made different choices having more options available to them.

    Being knowledgeable is the key. Always get all information, make sure you get the loss properly assessed by someone other than your insurance carrier, and then make an informed decision.

    With that being said, I am glad your repairs are going well and you are satisfied.

  365. September 7th, 2010 at 12:19 pm #Maggie

    Now that you put the doubt back into my mind, I will contact my adjuster and make sure the contractor did not jack up their price. Thanks for the warning…

  366. September 7th, 2010 at 12:46 pm #Public Adjuster

    Maggie,

    I certainly didn’t intend to put doubt in your mind. If things are going great – then awesome. The intent of my message is to make people aware that they should be fully informed of what they are entitled to BEFORE they begin making decisions with what is most likely their most valuable investment. Doing this would involve having an alternate assessment done by someone that is knowledgeable in construction as well as insurance policies. I would imagine that a good PSP contractor would appreciate this approach making sure that all damages have been recognized.

  367. September 9th, 2010 at 11:45 am #Joe

    We received an insurance claim check made out to me and the mortgage company for water damage to the kitchen hardwood floors. The bank said they will hold the check in escrow and pay the contractor directly. The insurance adjustor assumed that all the hardwoods on the first floor should be replaced to ensure all the floors match.

    We are considering replacing the kitchen wood floors with ceramic tile. Per square foot about the same cost but the area would be contained only to the Kitchen. The tile would be much better suited for a kitchen in terms of durability and less susceptible to water damage.

    Since there is less square footage to replace; the total price will be less. Am I entitled to keep the balance?

  368. September 9th, 2010 at 12:51 pm #Public Adjuster

    Joe,

    Over the years, especially with many people being behind on their mortgage or in foreclosure, the mortgage companies have become tougher and tougher about releasing money. I deal with this issue on a daily basis.

    The bottom line is that they want to see that the house has been repaired and they are not left holding the bag on a damaged home if someone were to default. They will more than likely want to send an inspector out to verify the home is in good condition after the repairs have been done.

    Your question is in one of those gray areas. You’re not entitled to profit from a homeowners claim. So, “keeping the balance” for profit purposes say to go on a vacation or something.. no. Do people do it? Of course. But, you are entitled to keep the money and apply it to other areas of your home (e.g. paint/new countertops/etc. etc.)

    But, I have to caution you on future matters. The insurance company paid to replace your hardwood floor throughout. It seems like you are only going to replace just the kitchen leaving other areas as is. 1. If you have a similar loss again… and it damages the now undamaged areas.. they are not obligated to pay you again. 2. Although probably not significant, you may be waiving any depreciation withheld on the flooring that you would have been able to recover otherwise.

    There is nothing saying you have to make the repairs as outlined in the adjusters estimate. However, your mortgage company may take issue with this. If they do, then that becomes an entirely different battle in and of itself.

    Hopefully others are able to provide their opinions on this matter.

  369. September 9th, 2010 at 9:09 pm #Jason

    Joe,
    The insurance company paid to match the undamaged portion of your home but they have settled your claim in the way that they have and if you wish to do it another way like you suggested, then you can do that.

    If you have another claim for the undamaged floor that you left as wood, that would be an entirely different claim and in no way related to your current claim. As for the prior advice that indicated the insurance company is not obligated to pay for the now undamaged areas, that is not entirely correct. In fact, you would be fully insured for the tiled and the wooded areas and there would be nothing held against you in the form of depreciation based on what you do with this claim. The insurance company insures your property for replacement cost and if you do not replace undamaged material, you are fully covered and your choice to make a matching decision different from your claim proceeds is perfectly ok to do.

    Your choice of repairs for damaged areas does cause you to waive any depreciation withheld or considered.

    I agree entirely with Public Adjuster on all other parts of their advice.

  370. September 9th, 2010 at 10:31 pm #Public Adjuster

    Jason,

    That is not what I understood Joe to say. He stated the adjuster paid to “replace” all the wood floors on the first floor so that they would match. Now, rather than replace them.. Joe wants to tile the kitchen but leave the remaining wood floors alone. If he has another claim.. with the same insurance company.. they do not owe to replace them again if he chooses not to replace them now. Although that portion of the floor did not receive direct physical water impingement.. it was continuous with no effective break or stopping point. So the adjuster paid to replace those areas also to achive a reasonably uniform appearance throughout. Joe is taking advantage of the situation by only replacing the “damaged” portion which is the kitchen with a different flooring obviously breaking it at a doorway. With your train of thought, Joe could have a water loss in each room and have the insurance company pay for the “continuous” flooring over and over again multiplied by the number of rooms he has on the first floor. So, lets say the dining room is damaged next… he replaces that with tile but you say he is owed for all the wood flooring again minus the kitchen. Then the next loss he is owed for all the wood flooring again minus the kitchen and dining room.

    I stand by my original advice that if he does not replace the flooring now which they have paid for, and he has another similar claim that involves the unreplaced wood flooring, they will reject his claim for the overlap. Obviously that is if the adjuster pulls the previous file and confirms this. If not, or if he switches carriers, then the chances of getting paid twice on for the same item are pretty good.

  371. September 9th, 2010 at 11:06 pm #Jason

    Public Adjuster,
    Thanks for you input.

    Joe is taking a matching “hit” by going with tile instead of going with a continuous match of the wood floor. He is not required to replace undamaged flooring if he can accept the “match” issue.

    I do say that Joe is welcome to do his proposed plan and it will be repaired to a pre-loss condition without replacing the undamaged flooring. Joe doesn’t need to be concerned with the unrealized depreciation that you have mentioned because it won’t concern him if he has another loss involving the flooring because the insurance company will look at a new situation if there is now tiled flooring and wood flooring. The continuous nature of the wood floors is being eliminated by his repair resolution and he will be fully insured for tile flooring and the wood flooring that is adjacent.

    I stand by my advice that the insurance company will not settle a future claim by holding this over his head. If an insurance would pick a battle over something this trivial, then perhaps their claim settling methods should be reviewed and refined so they don’t merge current claims with prior claims that have already been settled but not done exactly as outlined in their settlement estimate. Reading too much into this would be a disservice to Joe, who posed the question.

    Since Joe’s original question inquired whether or not he is entitled to keep the left over funds if he makes the correction to the damaged flooring by doing a tile floor instead of full wood floor replacement, I think we both agree he is entitled to keep that extra amount if not used in his method of repair since he is ok with the match issue between tile and wood. I also think we both agree that it is reasonable not to replace undamaged flooring if he can endure a flooring surface change that is acceptable. Joe also shouldn’t be concerned that the insurance company won’t pay for flooring that may become damaged in the future because the insurance company will pay for flooring that may be damaged in a future loss. Losses are considered fortuitous and if damage occurs to either the undamaged flooring or the replaced flooring, the flooring is nevertheless undamaged prior to any future loss.

  372. September 14th, 2010 at 8:24 pm #steve

    I signed up with a new insurance company for my rental unit on the same day we had a torrential rain here in Wisconsin. W had 7 inches of rain in 1-1/2 and our flat roof caved in and all the water rushed down into the units below. They are denying the claim because they found a football stuck in the drain for the downspouts and that’s what caused the water to back up and the roof collapsed from the weight. I had no idea it was up there, can they do this?

  373. September 14th, 2010 at 8:38 pm #Jason

    Steve,
    I don’t know what exact policy you have for your dwelling unit and unless that is known, it is difficult to address. Is your insurance company denying because coverage did not exist at the time of the damage? Is your company denying coverage because there is no peril that provides coverage for the damage? Is collapse from the weight of rain or water excluded? Do you know the form number of your policy such as DP-1, or HO-003 or similar to this? This information can be found on all pages of your insurance policy. That may be helpful if that information was known. Thank you.

  374. September 20th, 2010 at 3:52 am #Chris

    Back in March of this year i was making a delivery to a residential home and ended up being bite by the homeowners dog in his driveway. I had a significant bite to the left underarm area, and was clawed on the side of my chest. I was able to drive my truck home that evening, though it was very painful. As soon as i got off work i went to a local patient first. they gave me a tetunus shot, and cleaned up my injury. I didnt need any stiches or anything like that however 6 months later and i do have 2 scars from the teeth of the dog. Puncture marks from the dogs teeth. After having to run around and get medical release forms from patient first and print photos of the dog bite to the insurance compnany they have offered me 1250.00 for my bodily injury. Since i did miss 2 days of work they will cover that also but its a seperate check with workers compensation. I felt that 1250.00 was a bit low initally. What are my options, can i argue for more, or is this a fair amount? Ive never been through anything like this so i dont know whats a fair offer and whats not. Thanks you for your time.

  375. September 20th, 2010 at 5:41 am #Jason

    Chris,
    You questioned if $1250 is a fair offer. Based on what you indicated, the review of your claim is based on your pain and discomfort, scratches/scars, lost wages, and medical bills directly related to this incident.

    An adjuster is there to facilitate the settlement of claims and they review each claim based on it’s merits. They also review prior claims similar to yours and base their offer of settlement using the prior claim settlement numbers as a guide to know what amount is fair.

    Only you can determine if the amount they offered is fair. If you don’t, you can express that concern to the adjuster but you should back up the amount you want by explaining how it affected you. For example, dog bite scars on a face will usually require a higher offer for settlement than scars below the neck-line. A scar on a woman’s face will generally settle higher than a scar on a man’s face, for another example.

  376. September 21st, 2010 at 12:07 pm #jan

    I recently moved into an apartment complex that requires renter’s insurance. I called the number that they gave me to obtain the required insurance and was told that the total amount that they would insure for the policy was $25,000 which was not enough coverage for my personal property. The agent helping me, Michelle, referred me to another agent, Andy in her company to see if he could get me more coverage. Andy wasn’t able to help me and when I called Michelle back to let her know, she said that I could get two policies, one in my first name and last name and the other in my middle name and last name. She signed me up for both policies. I met someone out who was experiencing the same dilemma and I told them what I had to do and they questioned whether or not it was legal. I honestly did not consider it when I was talking to the agent because I had so much going on and I just needed to get it done. It was absolutely not my intention to do anything illegal, have I?

  377. September 21st, 2010 at 12:56 pm #Public Adjuster

    I’m not an attorney nor do I claim to be one or extend legal advice. I can give you my opinion based on similar situations and a vast knowledge of the insurance industry. Just an opinion okay?

    1. Stop worrying. You didn’t do anything wrong. I think your agent should be worrying.

    2. Probably let go of the 2nd policy. There are going to be insurers out there that will give extended coverage or add “riders” to raise specific policy limits where needed. For instance, if you need additional coverage for art work, jewelry, rugs, etc.

    If you had a claim where you needed both policies to kick in I would imagine you would most likely get paid eventually. But I don’t think that is the situation you want to be in because it’s going to get weird. I just don’t think you need to be in this situation at all because there are policies out there that will cover you under one policy. Your agent would have some answering to do I would imagine – but basically you did what you were instructed to by your agent.

    But, just get out of that situation. Once a claim is filed and you try to get coverage under both policies it’s just going to turn into chaos. You’re paying for two separate policies – it’s not like you’re trying to be doubly insured for the same items.. you’re just trying to get “full coverage”. It’s just the way your agent is going about it by creating another entity using your middle name making it as if it is your first name. Very peculiar.

  378. September 21st, 2010 at 7:22 pm #K Peak

    I have not been able to live at home due to water damage for a week now. So I have had to board my dogs. Is this something that I can claim as part of expenses incurred due to loss of use?

  379. September 21st, 2010 at 7:38 pm #F MICHAEL CONTE

    Yes it sounds reasonable

  380. September 22nd, 2010 at 9:46 am #Jennifer

    We own an 8 yr old home and have extensive water damage and rot in the entire front door frame (frame consists of side transoms and top transom with double pane glass). Just realized our HUGE foyer window above has rot all along the bottom frame on the inside! Wondering if any of that would be covered with our ins?
    Thanks for any info!

  381. September 22nd, 2010 at 10:04 am #Public Adjuster

    K Peak,

    Yes – you should be able to claim the costs for boarding your pet under “ALE” – (additional living expenses) assuming where you are living now does not allow for pets.

  382. September 22nd, 2010 at 10:14 am #Public Adjuster

    Jennifer,

    Most likely no. Most homeowners insurance policies do not cover things like “deterioration” or “rot” or damage caused by repeated seepage. Read your policy over carefully though. I did come across a policy a few years back that actually did cover “hidden decay”. This was a Hartford Insurance Homeowners Policy. That is the only policy I have ever come across that I have ever been able to get coverage for damages that would be long term in nature involving rot.

    Basically the insurance policy is designed to cover “sudden and accidental” damages and not damages that occur over an extended period of time – whether or not you are aware of them.

    You did state that your home is 8 years old. You may have recourse against the home builder. If the wood has rotted out clearly the leak has been ongoing. Have a contractor/leak expert/roofer inspect the area and determine where the leak is coming from that is causing the rotting. If it is due to improper construction/design – then that may be your best avenue.

    But first read your insurance policy.

  383. September 22nd, 2010 at 2:49 pm #Jason

    Jennifer,
    It is difficult to assess coverage for your door condition especially when it is referred to as “rot” because that is a prominent excluded item in almost every insurance policy. Public Adjuster has a good point in that hidden water damage may be covered if it is hidden and unknown in some insurance policies.

    The only way to determine if there is coverage for the damage is to make a claim and have the insurance adjuster investigate to determine if it’s covered. We are not able to inspect and determine coverage over this forum for you and the only definitive way you are able to know for sure is to make a claim and have the adjuster determine if coverage is afforded by your policy. A good adjuster will look for coverage when presented with the facts of the loss. Good luck in whatever you decide to do.

  384. September 23rd, 2010 at 5:51 pm #Caroline

    Hi all 🙂

    I have an present claim with my insurance company (nationwide). My whole 1st floor (kitchen, dining, living room) and the basement. At first they were great coming out assessing the damages within a day, actually had someone go through my lost things in the basement and document them, and then asked me is there anything else, at that time my head was so flooded with thoughts, i had no clue what else was covered in this lvl 3 water damage. We were pulling things out of the water and throwing them in the garage at 4 am in the morning. After waiting 2 weeks to hear from them, i called and they said oh were sorry your adjuster is on vacation for 2 weeks?? So i have no choice but to wait till he returns? I called a private adjuster and now he is involved. 2 weeks later the same adjuster is on vacation again?? 2 – 2 weeks vacations within 2 months? (i want that job). Any way i have a questions. The adjuster is negotiating the building part of it. and that is fine. But i also have alot of personal property damage. I also understand although i have RCV, i only get the ACV up front and when replaced, the rest.

    Questions:
    1. I have other items when finally going through things that were damaged, can they still be added? I took photos and all that jazz.( i recieved a check ACV for the items the adjuster saw that day if i deposit that am i giving up any rights for additions?)

    2. Do i have to replace the item with the same??
    For example, I had 2 Jeep cabin tents valued at 299.99 a piece, Fact is we don’t really “tent” camp anymore, we bought a travel trailer a few years back. Do i have to replace the tents with tents or can i buy some other camping item equal to its value? Or like i had 2 tv’s downstairs that were damaged. do i need to buy 2 of them, or can i buy one at the value they gave me for both.

    3. Can I have Like a flooring company do the floors and a general contractor do the kitchen, (cabinets, walls, painting , etc.)

    Thank You so much in advance, I have read through alot of the posts but none really answered my questions. So if i’m duplicating I apologize.

    I want to replace my items I don’t want the ACV cash out amount.

  385. September 24th, 2010 at 9:43 am #Jason

    Caroline,
    You can add other things that were damage. Just coordinate getting those things added with the adjuster. Cashing your first check should not infringe upon you adding additional items.

    Yes, you have to replace the items with the same. If you have a 10 person tent, you could replace it with an 8 person tent, for example. If you purchased binoculars and a portable camping grill in place of the tents, then you would not receive any additional payment.

    If you take the money you received for 2 tv’s and purchase 1 tv, you will be paid the recoverable depreciation for 1 tv, in this example.

    Regarding your question 3: Yes.

  386. September 27th, 2010 at 1:32 pm #Lisa

    I live in Texas adn last week our neighbor’s very large oak tree fell and landed on our house and into our pool. There was nothing weather related that caused it to fall but it had already lost most of it’s leaves so it was probably dead or dying. They contacted their insurance company (State Farm) who told them that they would only cover any damage up to their fence line and that we were responsible for filing for our damages with our insurance company (also State Farm). Their only damage is a tree trunk and part of the trunk in their yard along with a broken fence.

    It looks like we have damage to our fence, roof, gutters, pool and decking in addition to the cost of removing a large tree from the pool and house. When I called State Farm, they said that we would be responsible for paying $1,000 deductible even though it wasn’t our tree or from our yard. Don’t the neighbors have some liability for their insurance to pay for this even if we both are with the same company? I’m not sure why we should be out $1,000 for their tree!

    In the meantime, we are now on the 4th day of having the tree there with no end in site of having it removed since one of their claims representatives told us to go ahead and have it removed (at our cost) and another one said they needed to inspect it. It’s all very confusing and nothing is getting done. Any advice on how to proceed with this?

  387. September 27th, 2010 at 2:15 pm #F MICHAEL CONTE

    lISA,
    IF THE NEIGHBOR KNEW THAT THE TREE WAS SICK OR DYING AND DID NOTHING TO MITIGATE THE SITUATION, YOU WOULD HAVE FIRST DOLLAR PROTECTION, BY PROVING NEGLIGENCE. SINCE THAT APPEARS NOT TO HAVE BEEN THE CASE THE DEDUCTIBLE IS YOURS TO ABSORB. AS FAR AS THE CLEAN UP, TAKE A PHOTO OR TWO AND GET SOMEONE IN TO REMOVE THE DEBRIS. KEEP IN MIND THAT YOUR CONTRACT PROBABLY HAS A DEBRIS REMOVAL LIMITATION, WHICH YOU AGENT SHOULD BE ABLE TO TRANSLATE FOR YOU. ALSO SINCE YOU ARE HAVING TROUBLE GETTING THE STRAIGHT ANSWERS ASK YOUR AGENT TO GET INVOLVED, I AM AN AGENT IN ny AND I DO THIS ALL THE TIME FOR MY CUSTOMERS. FINALLY GOOD LUCK.

  388. September 27th, 2010 at 2:34 pm #Jason

    Lisa,
    F Michael Conte has some good information about your situation. The mere absence of leaves on a tree does not indicate your neighbors are liable for your damage to your property. However, if the tree was dead, decaying, or to the point where your neighbor’s should have taken action to remove the tree but didn’t, then they may be liable for the damage to your property. However, sometimes trees fall without having an outward appearance that they will, especially large oak trees that can crack from their own weight. I don’t know what the tree looked like before it fell but since you didn’t indicate its condition as obvious, the its fall was likely unexpected and unforseen.

    You should take actions to prevent further damage or to protect your property as much as you can, if needed. This would be at your expense and should be reimbursed by the insurance company. If a representative indicated they want to look at it first, simply do what is absolutely necessary before they arrive so they may inspect it first. If the insurance company is sending someone out to inspect, that adjuster may be looking at the tree to determine if the damage to your property should be covered due to your neighbor’s negligence but don’t count on it. Your insurance is there to protect you and it doesn’t matter if the tree is yours, your neighbor’s tree, or one that was blown in from a tornado that belongs to a neighbor 20 blocks away. The insurance covers damage to your property no matter whose tree caused the damage.

    This is one you may want to ask your agent to become involved with because agents are not only there to make sure you have the right kind of coverage, they are also there to make sure things go smoothly when you need your coverage to respond.

    Mr. Conte is correct that there is likely a limit on tree removal so don’t go overboard on this coverage. Make sure you stay within your limits to get the tree debris removed. Now, the coverage for your fence, roof, gutters, pool and decking should be more adequate for the damage that occurred to those items.

  389. September 28th, 2010 at 9:40 pm #Misty

    Recent storm caused damage to my home. This was considered a catastrophic event do to number of homes damaged. My insurance company was responsive and called in asjusters from out of state. They came out and lolled at my house 3 days later. The adjuster called me the day after he was at my house and gave me the results and told me I would receive my check and information packet in the mail. I received the check 5 days later. 4 days later I received a call from someone that said they were with my insurance companies catastrope audit department and they would be at my house within 5 days to review the asjusters estimate and measurements. I have nver heard of this and I talked with several others and no one has ever heard of this. Since on the same day i got the audit call I received a “nice” letter stating my homeowners INS rate was increasind due to claims paid in our state, I’m nervous they are gonna say in the audit they made a mistake and ask for funds back. My roof is scheduled to be replaced in 3 days. Any ideas on what the audit is or what can come of it?

  390. September 29th, 2010 at 9:17 am #Public Adjuster

    Misty,

    This is fairly normal for an insurance company to do this especially when the catastrophe team is called in. Often times the catastrophe unit comprises of independent adjusters that are not employees of the company but rather hired on a temp. basis to assist in meeting the demands of the high volume of claims.

    So, what the insurance company will do they will select certain claims to review on each adjuster which is generally done randomnly and have their audit team review the claim and make sure the adjuster is not overpaying or underpaying. More than likely you will never even hear of the results – especially if they underpaid.

    If there is any recourse to be had, it will be against the Independent Firm they hired. If the adjuster did not measure correctly or if they overpaid something, they could possibly ask for money back from the independent company – but not you. If the adjuster is an actual company employee, then of course the adjuster could lose a bonus or be reduced a pay scale or something like that. But the issue is not with you, it’s with the adjuster.

    You should proceed with the repairs as planned.

    Hope that helps.

  391. September 29th, 2010 at 5:24 pm #Jason

    Public Adjuster,
    Nice job. That answer is better than the one I was going to post. While answering her question, you also provided her with the appropriate amount of comfort regarding the matter.

  392. September 29th, 2010 at 8:19 pm #Misty

    Thank you so much. That really puts my mind at ease. Not only have I been worried about record but fraud also since no one I have talked to has ever heard anything about this. We of course,have several scam companies in town and I was also worried about more strangers around my house!! You guys are wonderful!!! I will also post for a good company. American Family has been great. This is the 2nd cataastophe I’ve been in in 5 years and 2 different homes. They have been quick to respond and have never given me a hassle on the claims!!

  393. September 29th, 2010 at 9:02 pm #grant

    My wood roof was total loss from hail storm. I have paid premiums for 14 yrs to insure wood roof. Roofer estimated new wood roof at approx 17k as did the insurance co. I may decide to go with a less expensive comp roof. They are agreeing to pay approx 13k now and the other 4k when work is done. If I go with the comp roof am I not entitled to the remaining 4k ? I understand the comp roof will be less than the 17k but I have been paying premiums for wood roof. Should I not be paid the cost for replacing with wood even though I am probably going with a lesser expensive comp. Or is the insurance co only responsible for what is put on even though I have been paying for wood replacement. Would that be considered profiting from an insurance claim ? Again I paid premiums for a wood replacement.
    Thanks

  394. September 29th, 2010 at 9:33 pm #Public Adjuster

    Grant,

    Although you purchased what is known as an RCV (replacement cost value) policy, the policy states that your insurance company is permitted to pay ACV (actual cash value) and withhold the depreciation until the item is replaced with like, kind, and quality.

    You are entitled to the entire $17K when the policy conditions have been met. However, if you choose to replace the roof with a lesser expensive roof, then no you are not entitled to the depreciation withheld.

    Read Jason’s post above in response to Caroline who had a similar situation.

    I would consider simply going back with a roof that is of like, kind, and quality since you will be losing out on $4,000.00 that you are entitled to which would add a better roof to your home and value. You don’t necessarily have to go back with a wood roof, but you would need to go back with a roof that is of the same value.

    Whatever you pay for the new roof above the $13,000 – up to $17,000 is the balance the insurance company would owe you.

  395. September 29th, 2010 at 10:48 pm #grant

    Thanks so much for the info. Your site is great and thanks for the quick reply. I will look at some more expensive high impact or class 4 shingles that should get me close to the cost and value of the wood shakes.
    Take Care,
    Grant

  396. October 2nd, 2010 at 2:27 pm #debbie

    We had a house fire over Christmas Eve. Our Insurance company has covered everything with the exception of our furnace which was located very close to where the fire broke out. They say the fire didn’t cause the furnace to fail. This happened in December and the heater was on when we left the house to go to church and fire happened when we were gone. We arrived back and upon being let back into our home a few days later the heater was not working. It is obvious the fire had something to do with that. Do we have any recourse?

  397. October 2nd, 2010 at 4:55 pm #Jason

    Debbie,
    There are one of two things that may be going on here concerning you furnace. The first thing is that the insurance companies don’t cover the cause of the fire. If they are excluding your furnace as the cause of the fire, then that is common industry practice to do that. My outlook on the situation is that the entire furnace doesn’t cause the fire, but only a part of it that did (and that part also damaged the rest of the furnace too). If the insurance company wants to exclude the part that caused the fire, then they need to isolate the part so they may exclude it. If they exclude the entire furnace, they are excluding the part that caused the fire and all other parts of the furnace. If you need a better understanding of this, I can explain further. I am not sure this is the reason for your concern because the way you posted the question.

    The second thing is that they appear to believe the fire did not damage the furnace. Simply have a heating contractor examine your furnace to see if the fire caused the furnace to fail. If the reason for the furnace’s failure is the fire, simply ask the contractor to write up a statement that the furnace was damaged as a result of the fire and have him detail why he comes to that conclusion. For example, a melted switch or melted wired that caused a capacitor or fuse relay to become damaged, or whatever reason or reasons he finds.

    It is more than likely that you have a open perils homeowner policy and the burden of proof that the furnace failure wasn’t caused by the fire, heat, smoke is theirs to prove. Simply make it easy for them and do the necessary leg-work so they have documentation why it failed so they can pay for the repair or replacement of the furnace. Good luck.

  398. October 2nd, 2010 at 4:57 pm #Public Adjuster

    If you are so certain that the heater went out because of the original fire, call an expert out and request an inspection of the heater and have them tell you why it isn’t working. You will have to pay out of pocket for the report. Then you will know or be relatively certain why it’s not working. Then present this to the insurance carrier if of course it is not working due to the fire. They may call out their own expert at that point but at least you have your report. If they end up relying on your report they should pay for the report as well as pay to have the heater fixed or replaced.

    Once again, if you are so certain this is the cause, then you have little to lose. It seems like it’s going to be something you have to do anyhow in order to get the heater fixed. Right?

  399. October 3rd, 2010 at 2:31 pm #c wilson

    had house fire , 2 boys inloved , can i sue other family for half of loss and should there homeowners ins pay , live in nv

  400. October 3rd, 2010 at 5:07 pm #F MICHAEL CONTE

    Mr. Wilson,
    You need to give us more information. Did the boys start the fire? is one of them your boy? did your insurer pay for your damage? what happened, how did the fire start?
    thanks
    fm conte

  401. October 3rd, 2010 at 6:09 pm #c wilson

    on the 30th of may 2009 we started gettin txts that our house was on fire we were out of town due to hospitalization . the fire marshal was called it was deemed feloney arson , both boys were 10 at time , next mornin were arrested , one use mine and other a family in town on feb 17th of 2010 and on march 17 of 2010 they were charged with public nusiance fined 10$ and 6 mo comunity service and on sept were declared finished , since then there was resitution on our half we only rented , no we didnt have renters ins , but i do now , not understanding nv law , my landlord said they had really good ins and paid dearly for it . the other family denies the child had any doins in it , we lost every thing we had , we started over new address and had to purchase everthing from our own pockets , they own a house 3 vechiles and recently did upgrades . he i know makes more then 80th a year , can i go and file against them and there home owner ins as it was half there fault . it cost me time ,loss of house and contents , homelessness, mental anguish , and my car in shop as it was melted and my car ins paid for all of it wich i think was not fair

  402. October 3rd, 2010 at 6:12 pm #c wilson

    oops , from statement last entered , sorry there was no restitution at all judge said it was a accident comitted by 2 kids

  403. October 3rd, 2010 at 6:22 pm #Debbie

    Thanks for your responses. I should have been more clear. The fire happened 2 years ago so we have already replaced the furnace. The furnace had nothing to do with the cause of the fire, that was from a utility lamp being left on in the basement and clothing falling on top of it. We thought the insurance was going to cover it but when we submitted all of our reimbursements they said that because it was a cracked heat exchanger that it couldn’t have been caused by the fire. All I know is that it was working fine when we left the house that evening before the fire and was not working at all after the fire. The technician who replaced it said it was probably caused by extreme cold (the electricity was off for several days and it was the end of December and the house stayed at about forty degrees on the main floor, probably colder in the basement). Do they have to give us their denial in writing and if so, what can we do to appeal their decision? I’m not even sure I can find the technician that put it in, he was an independent contractor and if I could he would even remember. Hopefully I can and he will remember and put it in writing for us. The cost is $3000 and definately significant to us.

  404. October 3rd, 2010 at 7:02 pm #Public Adjuster

    Debbie,

    In my opinion your chances of recovering in this situation are slim to none. What you needed to in regards to getting a report wasn’t done. You verified the heater part didn’t crack due to the fire but rather extreme cold. That could have possibly been submitted as consequential damage to the loss but that’s a long shot. Finally, if the claim happened 2 years ago, depending on when the claim was formally closed you have one year to submit any additional claim or your statute expires.

    The carrier does need to put in writing why they are denying this portion of the claim though. So, if they haven’t, I would ask them for the reasoning and put this reasoning in writing and how it is applicable to the policy provisions.

  405. October 3rd, 2010 at 7:04 pm #c wilson

    opps wrong comment i think i got wrong response from who ever , they emailed a response from someone else

  406. October 3rd, 2010 at 7:07 pm #c wilson

    dear public adjuster plz send comment to debbie at her email as iam getting them on my email thank you much

  407. October 3rd, 2010 at 7:28 pm #Public Adjuster

    cwilson,

    I don’t control who gets responses or where they get them. I post just like you do. I think the way it works is that when you subscribe to the thread you get notified of all new posts and not just the ones that are related to you.

  408. October 3rd, 2010 at 7:30 pm #Jason

    c wilson,
    No, there is nothing you can do. It was accidental, the children are minors, and the parents who have insurance didn’t have anything to do with it. You may get different answers but chalk this up as your loss and move on with your life.

  409. October 3rd, 2010 at 7:42 pm #c wilson

    i do know that in the state of nv that age 8 is accountablity for what they do wrong , but as u say move on thank you

  410. October 3rd, 2010 at 9:48 pm #javier mora

    I My house burned, The insurance company would like all contractors bill me and sign work authorization before for all repairs. Don’t they have to bill the insurance directly?
    They want me to pay the tax as well.
    What shall I do??? need help.

  411. October 3rd, 2010 at 10:28 pm #javier mora

    One more question, two townhomes next to the fire got damage,
    the insurer want me to agree for payment with contractor before work is done…..isn’t this a insurer duty?

  412. October 4th, 2010 at 5:20 am #F MICHAEL CONTE

    Your final comment says it all.
    i donth think there is anything you can do. Protect yourself in the future and move on.

  413. October 4th, 2010 at 5:47 am #Jason

    javier mora,
    It is appropriate for the contractors to bill you. The insurance companies presence is to pay for the repairs. The insurance company doesn’t actually hire the contractors to work on your property since you are the one that has authority over your property and who works on it.

    Yes, the insurer should be taking care of the townhomes with the townhome’s owner and not you. You should have nothing to do with those properties.

  414. October 7th, 2010 at 3:10 am #song eavey

    Hi my home is destory by fire and later I found out my husband set the fire. He has bipolar dease for last 6 years and has been in and out of jail. Insurance company will pay my share of helf of total cliam. My question is my husband have to pay back insurance company for my cliam? I just lost about $200,000 because of fire.
    Please let me know
    Thank you
    Song Eavey

  415. October 7th, 2010 at 9:43 am #Public Adjuster

    Song,

    That’s a tough situation you are in. In my opinion I think you should seek out a qualified attorney that is very knowledgeable with insurance law and quite possibly also a public adjuster to assist in assessing the full value of the damages. The two should have no issue working together. There are a multitude of issues that would need to be sifted through that I seriously doubt could be gone through in this forum.

    You state that the insurance company is paying half of the claim. You need to clarify this. Are they paying only for 1/2 of your personal property or actually paying 1/2 of the value of the damages across the board – meaning the structure also? If this is the case, do you have a mortgage or is the house paid off? If you have a mortgage then the insurance company cannot get off the hook that easy to only pay 1/2 of the structure because at the very least the have an obligation to the mortgage company for the structural portion of the claim.

    There are other issues also that need to be weeded through. You state your husband started the fire. Then you state that he has been diagnosed with bi-polar. But you never state whether he started the fire intentionally or was he doing something that started the fire like smoking, etc. I assume he started the fire intentionally since the carrier is only paying 1/2 the claim. But.. I’ve seen stranger things done by an insurance carrier.

    Like I said, seek legal help. Maybe Jason can add some more insight to your situation.

  416. October 7th, 2010 at 6:54 pm #Jason

    song eavey,
    Thank you Public Adjuster. You have provided the best information concerning this.

    Your question was whether your husband will have to pay back the insurance company for your claim. Had it not been for your husband intentionally setting the fire, the claim would not have materialized. He seems to be the reason that the insurance company would pay half of the your total claim. It seems very logical that he would be asked by the insurance company to pay back any payments made because of his actions.

    I am not an attorney and this is not a legal opinion, just my personal perception of the situation. There is case law that goes both ways concerning payment of a claim caused by the intentional acts of an insured. One specific case law stated that no insured could collect because of the intentional act of another insured that caused the damage. Payment by insurance companies is based on accidental, not intentional acts. I believe this was a claim involving Allstate Insurance Company but I don’t recall the specific state of this case law.

    Subsequent case law has changed so the innocent insured does not suffer the consequences of the insured who caused the damage. This seems to be a very controversial position concerning innocent insureds and insureds who intentionally damage the property. Public opinion and public outcry seems to have swayed case law so innocent insureds receive the protection of their policy while allowing the denial of the rest of the claim for the insured who intentionally caused the damage.

    Again, Public Adjuster stated it very accurately by indicating you should contact an attorney about the entire situation. I would contact an attorney even if you are under the perception that the insurance company will pay your half of the total claim. You seem to be in a very complicated situation.

  417. October 8th, 2010 at 5:13 am #song eavey

    Thank you for fast response. My home worth 350,000 and I made down payment 70,000 so I have mortgage about 280,000. I File for personal property for 75,000 and they divide that by helf minus depreciation so I received about 15,000 for personal property in July. I have seen the lawyer for help but lawyer said since my husband set the fire I can only get helf of total cliam. I received phone call from insurance company ask me to send payoff mortgage paper work so I send and received e-mail saying that its going to take about one week for his boss to approve. So I think end of the month I should be settle with insurance company. My husband in the jail since May and wait on Grand Jury. Before house fire, I had one house is paid for and another house is he just bought last year when he had bipolar symptom, but we didn’t have any death, we had three vehicle is allready pay for and I have a small business. After fire he loss his retire pay from Army and VDOT. I’m came from another country and I don’t speak minimun English. I try to find information on internet for months luckly I found your site and I’m very thankful for this site.
    Thank you
    Song

  418. October 8th, 2010 at 10:08 am #Public Adjuster

    Song,

    I still recommend getting legal counsel on this matter. From what you stated the insurance company is going to pay the structural portion of the claim which is the correct thing to do since they have an obligation to the mortgage company also. If you only received $15,000.00 of $37,500.00 for personal property – it seems to me whoever calculated the depreciation was a little excessive. When I was an adjuster for insurance companies I never went over 50% and that was for items like old clothing or magazines or something like that. If it is recoverable depreciation then fine – but you need to replace your items fairly quickly so you don’t lose out on the $22,500.00 they withheld. There are time limits you need to comply with.

    I wish you the best in your situation.

  419. October 17th, 2010 at 2:20 pm #Gary

    I was injured in a fall on a neighbor’s property. I was helping him tear out an old porch when I lost my footing and injured my shoulder and foot. This was a “free” neighbor helping a neighbor type of situation and not for any kind of payment. Would my neighbors homeowners insurance cover my out of pocket medical expenses and my loss of income ( I can’t work until I heal and my doctor will let me go back to work).?

  420. October 17th, 2010 at 5:33 pm #Jason

    Gary,
    If your neighbor has insurance, it is very likely that his insurance would pay your out of pocket medical expenses. I don’t know about loss of income though. From your explanation provided, it sounds as if a simple accident and the insurance company would not pay for more than medical expenses.

    Some employers provide (or allow the option to buy) disability insurance and this may be the type of insurance that you could utilize if you have had it at the time you were injured.

  421. October 24th, 2010 at 12:54 am #Mike

    I had wind and hail damage to my rental home in Ohio (it’s actually 2 homes joined by a deck, counted by the ins co as 1 home) that my contractor I’d signed with said would cost $40-$45,000 to repair, and submitted the evidence to the ins. co. The ins. co. sent out a guy who, IMO, basically made up a lot of stuff and then they made out a check for all of $3,578.40. The contractor I signed with saw the guy do his examination and noted that he didn’t even follow the Hague standard to which he was supposedly applying. He told me their whole process was extremely peculiar, one in which he’d never seen any other ins co do, and he has homes approved every day with far less damage. The ins. co. hired guy even noted guy even wrote that the garage wasn’t even damaged when there isn’t even a garage attached anywhere or any kind of garage door anywhere. I wasn’t born yesterday, and my dad and brother were both into construction, roofing, etc, my dad for almost his entire life, and I know I can’t possibly make the place livable for this amount, no matter what their “expert” claims. This was the contractor’s opinion as well. Do I have to accept or cash this check? Do I have any recourse? I did have damage to my own home which they repaired earlier in the year (they used an entirely different process then), so I know they don’t want to cover another one, and I sympathize, but I didn’t cause the hail or wind and thought this was why I paid my premiums.

  422. October 24th, 2010 at 8:17 am #Jason

    Mike,
    The $40,000 to $45,000 is fairly vague. What does the estimate your contractor wrote indicate the cost of repair would be? There are different ways to repair things when it comes to roof damage. Are all slopes damaged by hail/wind or just some slopes?

    Are you referring to the Haag method for checking for hail damage? If so, that method can be modified a number of different ways to achieve the same end result.

    Insurance is not a get-rich-quick thing and the damage done by hail/wind is fairly definite. $45,000 and $3578.40 have quiet a bit of variance and it is impossible to determine the extent of your damage though this forum.

    No, you don’t have to accept or cash the check. You can ask for another opinion from the insurance company.

  423. October 25th, 2010 at 11:50 am #Public Adjuster

    Mike,

    I agree with Jason that we need more information. I don’t read anything into you trying to “get-rich-quick”, so I’m not sure what thats about.. in fact you mention you cannot make the home livable since you can’t make the repairs for the amount they gave you. So, taking you at your word, request that the adjuster and supervisor, and a contractor of theirs come back out and re-inspect the property with you and your contractor present. Go over their estimate and compare their estimate to yours. See if their own contractor agrees with them. In many states if a homeowner is unable to have the repairs done for the price and scope that the insurance company has issued, then the insurance company is required to provide the insured with the name and contact information of at least one licensed contractor that is willing to do the repairs for that amount. You can pin their contractor down at the meeting and put him on the hot seat and see if it can be done.

    You need to figure out why there is such a difference. You need to figure out what “physical damage” they did not include in their estimate that your contractor did. If your contractor is simply stating something like “replace the entire roof, felt, decking, gutters, etc.” and they are only replacing one slope – then find out why they are only replacing one slope. Is it because that is the only slope that received direct physical damage? If so, are there matching issues with the roof? Possibly the adjuster thinks that the shingles can be reasonably matched and your contractor doesn’t.

    These are all issues that need to be resolved with another meeting at the property.

    I don’t know how the insurance companies operate in Ohio – but in most states that I am aware of you can deposit the check from the insurance company and it does not prejudice your rights to further recovery. I would imagine this is the case, but simply ask the adjuster and get it in writing that you are permitted to deposit the check while still retaining your rights to additional recovery if of course it is warranted.

  424. October 25th, 2010 at 5:21 pm #Jason

    Mike and Public Adjuster,
    I didn’t mean that to come across in the way it did by using that term. That was inappropriate of me. Sorry. I should have started my statement out with, “…the damage done by wind/hail is fairly definite”, without that reference since it certainly doesn’t belong.

  425. October 29th, 2010 at 1:53 pm #liz

    I had a house fire (TN) and my insurance company is not renewing my policy because of ‘total fire loss’. My policy ends 11/3 but my house is not expected to be done until January. I’m finding that no one will insure my house until the repairs are complete. Right now the new roof is on and the inside is down to the studs and they are working on the electrical. What do I do???
    I really don’t want to own what’s left of my house without insurance. I’m also confused about how this is called a ‘total fire loss’ when we are having to rebuild/repair?? (Everything had to be gutted as a result of really bad smoke damage, but the frame was fine)
    Also confused about contents claim. Have spent many hours working on this inventory, no where near done, and just recently found out that we get replacement cost on things we actually replace if we turn in receipts. How similar does an item have to be to be ‘like kind and quality’.
    For example:
    Can I replace Mizuno running shoes with Saucony and get the depreciation back?
    Can I replace a loveseat with 2 armchairs?
    And what if I upgrade an item? Can I get depreciation back for what it would have cost to get the lower quality item?
    Also, I have 2 small children and can’t get hardly anything done without a sitter. Is that a covered ALE?
    Thanks!!!
    Exhausted and confused

  426. October 29th, 2010 at 3:17 pm #Public Adjuster

    Liz,

    I have seen F. Michael Conte post on this site and as I recall he is an agent. Hopefully he can answer your question regarding the renewal of the policy. I think you need to look into a “Course of Construction” policy rather than your standard homeowners policy. These can be purchased through various agents. I’m not sure if the most popular names sell these such as State Farm, Allstate, Farmers, etc. But I know companies like Markel and Lloyds do. Check into that and see if that will meet the requirements. Otherwise your mortgage company will issue a “Forced Policy” which is going to be costly and cover only their interest in the property. Hopefully Mr. Conte can elaborate and let me know if I’m on target with this info or if he has better suggestions for you.

    As far as your contents; replacement should be similar. A shoe for a shoe. The brand should not matter. But don’t buy snow boots intending to replace slippers. You are exactly correct that if you buy something that is an upgrade, you would receive the recoverable depreciation on the lesser item. Not on the difference of the upgrade. Jason addressed this item in a very good post recently.

    When you are replacing items that are similar in likeness and cost, you shouldn’t be overly concerned. When there is an item that may be different and more costly, simply ask the adjuster if it is okay. Lets say you are going to replace a love seat with two chairs. You don’t want to run into any potential disappointment, so just ask. And when you are replacing something that is vastly different, lets say a microwave for a television, well…. you can probably save yourself some time by not raising your expectation that the adjuster is going to be that open. The adjuster has to document their file properly and generally has QA (quality assurance) review files for discrpencies.

    Regarding the child care; I would say that is a deep stretch and you’re probably not going to get that. You can ask the adjuster. But I doubt it.

    Sorry to hear about your loss and hope you are able to get things back together for you and your family.

  427. October 30th, 2010 at 9:12 pm #James

    We filed a home insurance claim due to the water damage to carpet and wall, our insurance company sent us a check with ACV. We need to submit all the invoices and recieves from the repair to get RCV back. We want to do a hardwood floor instead of carpet. My questions are: 1. can we use the insurance money to put a hardwood floor? 2. will it jeopardize getting RCV back?

  428. October 31st, 2010 at 7:47 am #Jason

    James,
    You should be able to use the money to put a flooring in that was damaged and it doesn’t need to be the same. If the cost of the hardwood is more than the carpeting, you should be able to get RCV back.

    Now, just so there is open communication between you and your adjuster, this question should be asked directly to that person so you can have the answer from that person. Although the answer will be the same, we don’t settle the claim details with you, your adjuster does.

  429. October 31st, 2010 at 10:50 am #F MICHAEL CONTE

    liz,
    Public adjuster is correct.
    you need a builders risk contract, or a homeowners with the cost of construction endorsement. you will not be able to get either from a captive agent company, as they only sell their products. you need to seek out and indepndant broker or agent who represents many carriers. the cost of this replacement contract will be higher that what you are used to paying, but i think you see how important coverage is.

    best of luck. i am not licensed in TN, so i can not offer more direction.

  430. November 10th, 2010 at 11:53 pm #Kls

    As I was searching the web for answers to questions I had, I a came across a very well written question which really addresses so much of the confusion we face with insurance and insurance claims. It was posed by Val in March 2009, #68, with your response #70. I was disappointed to see you just dismissed this question. Rather than even attempting to answer it, to help those you have sought to assist, you found the answer to be too involved, too detailed and told him to go read a book about it. Your answer would have provided many people very useful, insightful information from a person of expertise. Maybe you would be willing to readdress his question. I am very interested in his situation as I am sure many others are too.

  431. November 11th, 2010 at 9:32 am #Public Adjuster

    Kls,

    I re-read the post and response. The admin did answer the question by telling the OP to go get help. The situation that Val was in was far more complex to try to answer on this site. This is a bog where people like myself freely jump in and attempt to answer or discuss certain situations that are fairly straight forward and brief. Clearly 20 years of claims handling expertise on how to deal with a theft claim that appears it’s going down a bad path cannot be effectively spelled out on a blog. You make it seem like the OP was asking yes/no questions. That was hardly the case. The response was appropriate for the circumstance in my opinion and your verbal shots at the admin alluding that he/she did not want to help are out of line and unwarranted. This site provides a wealth of information to the public – and I’m sure a great sense of relief in some circumstances.

  432. November 12th, 2010 at 8:16 pm #Jason

    KLS, Although there is a lot of information in the original post by Val, there are essentially 3 questions and I will answer all 3 of them. The first question is, “Would the insurance company refuse to cover me if I accidentally left the door unlocked?” No, they would not refuse to cover you in that situation. The second question is, “Does State Farm (or any insurer) pay out for receipt-less jewelry or am I wasting my time making an inventory? All insurance companies pay for damaged items regardless if you have a receipt of not. The third question is, “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?” Yes, you would be able to take the allowance they gave you and add your funds to it and buy what you are happy with. ==== A question in that post by Val asked, “Wouldn’t it still be theft?” I know none of us on here want to address legal, law enforcement, or subjective issues because of their complexity so these questions are not the kind we will address on this forum.

  433. November 13th, 2010 at 2:01 pm #FM CONTE

    since this ball is back in play i would like to add two points.
    although i agree with jasons comments to val, it is important to realize that some carriers will still stand on “sign of forced entry”. second they may not honor a claim with out a reciept.
    there is no hard fast rule follwed by all, it depends on the carrier at the table, and the mitigating sircumstances surrounding the event.
    (just thinkiing out loud)
    fmc

  434. November 17th, 2010 at 7:13 am #Tony

    Looking for any expert advice.

    Tornado came through my neighborhood in Aug. Didn’t appear to be any damage to the house, but basketball poles and other large, heavy items were picked up and thrown into cars, causing a lot of damage.

    State Farm paid car claim without issue and we thought we were done, but a few weeks later houses all around began getting roof inspections and approved claims for entire room replacement.

    We weren’t even going to have an adjuster come out, but after every house around us (literally each and every house) was approved by insurance for new roof due to hail and wind damage, we thought it prudent to at least check.

    Roofer’s opinion was that there was enough damage to also warrant replacement. Insurance adjuster agreed that there was damage, but not enough to warrant replacement. Then he immediately approved the house 20 feet away (whose owner has a daughter that works for the insurance company –coincidence?).

    We are literally the only house in a two block radius to be denied. It seems somehow that Moses came down to part the storm just over our little section of the neighboorhood (never mind the car damage and tree damage on my property).

    Fast forward 3 weeks. Insurance company claims to have lost adjuster’s report (they found it eventually) and did nothing when we asked for another opinion.

    When second adjuster finally came out he claimed that there is no storm damage at all to the roof and it’s wear and tear of cheap roofing (house is 8 years old and roof is builder’s original).

    We’re at a loss. How could first State Farm adjuster admit damage but claim somehow our damage was less than every single house around us and second adjuster claim there is no damage at all other than wear and tear.

    Final insult to injury: The second adjuster approved fixing a leaking window that the first adjuster denied — but first adjuster showed us why he denied it and it totally made sense. It was not caused by storm but showed up because of unusally strong storm.

    Even my local agent admitting in a roundabout way that it seems like the second adjuster was throwing us a bone before he even got on the roof because he wasn’t going to approve it regardless of what he saw.

    We don’t know who to trust anymore. Maybe the roofer is exaggerating the damage (ok, not a huge leap there), but how can one adjuster admit hail damage to metal roof vents and cut a check on the spot and a second adjuster claim no damage at all?

    We’re still fighting. Looking into maybe a public adjuster. Trying to be honest here — not looking for a new garage door like neighbors who admit to us on the sly that the dent was from them hitting it with the car (besides, what kind of adjuster mistakes hail damage to a garage door with a car bump).

    Appreciate any and all thoughts on the situation.

  435. November 17th, 2010 at 10:10 am #Public Adjuster

    Tony,

    I think that you would need to first take the damage to your home and your claim on it’s on merits rather than trying to base what you feel you should be compensated for on the entire neighborhood. During the San Diego Wildfires in 2003 (I think) I inspected many homes burned to the ground while others 20 feet from each other were untouched and/or had little direct physical fire damage. Some claimants wanted their houses which were only partially burned completely replaced because all of their neighbors in the entire neighborhood had theirs replaced. So you have to stick to the facts of your own home and base the claim on it’s own merits. Each insurance company is different and each and every claim is different. Some insurance companies may just auto-pay these claims while others want more diffinitive proof.

    You state that you didn’t file a claim until every other house was approved. Which to me means that even you weren’t convinced at the onset that there was damage. In fact, you were convinced that there wasn’t damage because you didn’t file a claim. As I understand it a roofer looked at the roof and advised you that there was in fact damage and that the damage warranted replacement of the roof. Did the roofer put this in writing – give a written report?

    This is important. Let’s remember what an adjuster is. An adjuster technically is supposed to a.) verify coverage – often through visible damage b.) advise of coverage and how it applies to the policy and your particular loss c.) pay for and “adjust” indemnity to the benefit of the policyholder for a covered loss.

    An adjuster should basically be basing decisions off of experts and adjusting the loss accordingly (e.g. paying for damages, reviewing estimates, balancing out estimates, issuing payments, etc.)

    The work of an adjuster even though streamlined has broadened greatly over the years. Somehow adjusters are now often relied on as experts by management. Management will often take the adjusters opinion over an experts. This is a very poor approach by insurance companies.

    In your situation the roofer’s expert opinion should be carrying much more weight than the adjusters. I don’t care if the adjuster holds a license for roofing, that is not the capacity he is working in. So, if the adjuster has doubt for some reason that the roofer is correct, say for instance he believes the roofer is just stating the roof needs to be replaced because he wants the work, then he should call in another roofing expert to confirm the damage. I am assuming that the adjuster did not call the roofing expert but rather the roofer was there on your behalf.

    Anyhow – your approach should be to get the report from the roofer. A well written report with photos if it has not already been done. Then demand that the insurance company send out an unbiased “local” roofing company to meet with the roofer that wrote the report. If they refuse, then you call out another roofer and get another roofing report. Then, submit what is known as a “Proof of Loss”. This will get their attention and set the clock ticking on them to take further action. If the roofer bills for their report, include this in your demand for payment.

    But, I believe once you demand another roofer come out that they will comply. Make sure your roofer is there when their roofer is so they can discuss the damages together. Then follow up with the insurance company.

    Hope all works out well for you.

  436. November 17th, 2010 at 10:27 am #Tony

    Thank you for the reply. Makes sense. If the original roofer said you really don’t have enough damage we would have ended the conversation right then and there. But with the roofer and the first adjuster agreeing to damage from the storm (just not how much damage) we thought it worth following through on.

    I’ve got the first roofer’s written report and will have a second roofer come out tomorrow.

    Appreciate the advice.

  437. November 21st, 2010 at 11:53 am #sherri

    My son and i are in temporary housing in nyc, due to flood while our coop is fixed. My ex husband (co-owner with me, resides elsewhere), refuses to sign insurance claim check made out to us both or to cooperate . I suggested putting it in our joint fidelity thats still open . My adjuster says i may need lawyer.
    Questions: would there be anything in my chubb policy to address this issue.? What if ex gets lawyer? What can chubb do legally?

  438. November 21st, 2010 at 1:07 pm #Public Adjuster

    Sherri,

    I’m not an attorney nor am I giving you legal advice. Just my opinion/observations from facing this situation previously as an inside adjuster and also as a public adjuster;

    If you both had a divorce attorney go back to your divorce attorney. This issue should have been addressed in the divorce stipulation. Maybe not specifically but in general terms.

    There is nothing Chubb can do. You shouldn’t burden them with this situation. They are actually doing the right thing by listing you both on the check. Certainly there has to be someone in this small world of ours that could talk some reason into this guy. Anyone?

    Otherwise, yeah.. its a legal issue. If he is still on the insurance policy, and still on the title to the home, and it has not been addressed in the stipulation as to where any proceeds go to or who has care and custody of the home.. then as frustrating as it is you are more than likely going to have to have an attorney deal with this. If any checks are for personal property then that check may need to be split with him depending on what the items are and what the stipulation was.

    I wish in these situations people would just come to a reasonable solution. Especially since you have a son involved and more than likely Chubb will expire on your living situation – and rightfully so. See if a mutual acquaintance of yours can mediate the situation since clearly we don’t know the specifics of why he won’t sign off whether he is just bitter, he thinks you will pilfer the money, he wanted the house and you got it.. or whatever.. which none of it matters in this forum. But my first thought is there must be SOMEONE that could mediate this between you.

    I wish you and your son the best.

  439. December 3rd, 2010 at 3:57 pm #Jen

    In the past two years, we have had two homeowner’s claims. Both involved replacing the floor in the same room due to separate plumbing issues in the walls. On the first claim, the insurance company sent a contractor to assess the source of the damage. The adjuster came out within a couple of days to measure the room, make calculations, and cut us a check on the spot for the damage. One the second claim, we had water coming up through the floor that seemed to be coming from the dishwasher draining in the kitchen above. We shut off water to the kitchen immediately and called the insurance company. They sent a contractor out the next day to find the source of the problem. In doing this, they had to jackhammer through the floor of the room. The contractor was there for 3 days doing what we thought was still working on direction of our insurance company, but when they showed up with drywall, I grew concerned. I called the adjuster, who had showed up the day the contractor did, but still had never yet given us an estimate or cut us a check for repairs. The adjuster told us the contractor was doing the repairs. I told him that we had never received an estimate, and never authorized the contractor to do the repairs. I told him we had a contractor that we wanted to use, not theirs. My husband told the contractors that we weren’t having them do the repairs and they took everything and left. The adjuster sent a check to our house and told me that we did not owe any payment to the contractor. Four months later we received a bill from the contractor. We called the insurance company and they said that we didn’t owe anything to the contractor, that they would take care of it. Today we received a certified letter from the contractor stating that we have 15 days to pay them or they are taking us to court. We called the adjuster and he now says we owe the contractor. We called the agent, and and they told us that this is between us and the contractor. I don’t see how this is our responsibility for payment when we never engaged the contractor to do any work. Can you please advise?

  440. December 4th, 2010 at 7:37 pm #Jason

    Jen,
    The only person that can authorize work to be done on their house is the homeowner. This adjuster seems to have brought in a contractor, right? Who called this contractor in? It seems the insurance company coordinated the contractor to be out there and determine damaged and make exploratory demolition to determine the damage and it’s cause.

    It seems the insurance company is responsible for any expenses and charges that were incurred by the contractor.

    That is my assessment of your situation. The agent and adjuster associated with your insurance company may need to get involved until this is solved to your satisfaction.

  441. December 6th, 2010 at 9:47 am #Public Adjuster

    Jen,

    To further elaborate on Jason’s message;

    While it is true that in most cases the insurance company cannot authorize repairs be done to your home – I say in most cases because sometimes the policy has a clause that they can.. even though they never would.. they are permitted to investigate the claim by bringing in their experts to determine cause and origin and extent of the damage. Clearly you had knowledge that some type of work was being done at your home. The moment the jackhammer starts whacking away had to have been a pretty good clue. So, in moving forward I don’t think its the best approach to claim that you had no idea and never authorized repairs. At the very least you permitted some structural materials to be removed even if you didn’t sign a contract (which would be a completely different issue).

    The issue at hand basically boils down to whether or not the insurance company paid you directly for this work that was completed. Each time a payment is issued the insurance company is required to provide you a basis of the payment which is generally an estimate completed in some form of estimating program – Xactimate, MSB, Simsol or something like that or a written explanation of the basis of the payment. If you were not provided an explanation of the basis of their payment, then you need to request it. If you were provided an estimate then review the estimate and compare it to what the contractor is claiming you owe them. If you cross compare and it turns out the insurance company paid you for this work, then you are going to owe it. For instance, if you see on the estimate “open slab” or “jackhammer slab” and they paid you $750.00 – and the contractor is billing you for jack hammering the slab – then the insurance company fulfilled their obligation and you owe the contractor. Now, if you don’t see the items on the estimate that they paid against, then call the contractor up and explain it to them. Let them know that you don’t dispute that they worked at your home and they deserve to be paid, “so let’s call the insurance company and figure this out so you can get paid”. It could be an oversight on their part or possibly the contractor just never bothered billing the insurance company since they were under the impression that you were paid for it. This seems fairly simple to resolve. The only snag I can see is if the insurance company never paid for the work and claims they don’t owe for the work. If that is the case, then find out why they feel they don’t owe and post back here so someone can try and help with that situation.

    Hope this helps – take care

  442. December 6th, 2010 at 4:18 pm #Jason

    From Jens post, it seems the contractors were brought in to investigate with/for the adjuster.

    If the adjuster told the homeowner that they did not need to pay for what the adjuster used the contractor for (investigative and exploratory work), then the homeowner would not even be sent a payment for the contractor that the adjuster brought in. The homeowner should not be involved in payment for any type of adjusting which it seems the contractors was assisting. That would be similar to a homeowner having to pay the independent adjuster for coming out to their house, write an estimate, take photos, and submit a report to the insurance company. That doesn’t happen.

    The independent adjuster is hired by the insurance company, just like any experts, C&O people, or accountants as needed. Putting the homeowner between the insurance company and these people is not something an insurance company would do.

    For this case, any jackhammering is considered exploratory work (not demolition or removal because it is done with the adjuster there) and is not the responsibility of the homeowner.

    I have a feeling we don’t have all the information we need to provide more accurate help. That is why it is important to communicate with your agent and your adjuster until this is resolved to your satisfaction.

  443. December 7th, 2010 at 12:00 pm #Patrick

    Question: I have a Met homeowners claim (replacement cost) from a recent burglary. There are some items that I have no need for, though they have depreciated significantly. Is it illegal/fraud to purchase these items, submit the claim and then return them? I certainly don’t want to do anything fraudulent, but I also feel I’m untitled to the full value of what was stolen. Any advise would be greatly appreciated.

  444. December 7th, 2010 at 12:38 pm #Jason

    Patrick,
    If the items weren’t stolen, could you take the items back and return them?

    If you would purchase the items to get the recoverable depreciation, you would be in a better position after the burglary occurred.

    If you have to ask if it is illegal or fraud to do that, then you are on the right track. If you feel like you are entitled to the full value of the items that were stolen, please refer to my initial question above.

  445. December 7th, 2010 at 12:58 pm #Public Adjuster

    Patrick / Jason

    That’s actually a very interesting question. I interpret Patrick to be saying that the items were stolen and he wants to recover the depreciation by purchasing certain items that he really no longer wants or has use for.. and then return them to the store he purchased and keep the money.

    Would you mind elaborating on your response Jason because I’m a little confused? I am not clear on what you mean by “refer to my initial question”. Thanks.

    My initial thought was that there was nothing wrong with this.. but then thinking it through… there actually may be. Patrick.. if you received the ACV for the item it’s because you actually were able to use that item for however many years.. which brought you value.. then you were paid the current market value of that item that was stolen. So that is the “full value” of the item. If you are purchasing the new item with full knowledge that you are going to return the item and pocket the cash.. then like Jason said you are in a better position (monetarily) then you were before. In a homeowners claim you are entitled to be restored but not entitled to profit from a loss (except for very rare circumstances). In this case you would be profiting from the loss and therefore I think you could create a potential situation for yourself if it was discovered. It’s doubtful it ever would be.. but that’s not the question or issue you posed.

    My recommendation would be that you find similar items that you would like to keep or use and get them approved by the adjuster prior to purchasing them. You shouldn’t approach this situation with the mindset that you are losing something if you don’t get the Replacement Cost Value. Like I said above, you were able to utilize the item for X number of years.. and then you were paid the current market value of the item. So you have been fully restored.

  446. December 7th, 2010 at 1:57 pm #Public Adjuster

    Patrick,

    I think you posed an excellent question and I was somewhat stumped to be honest. I even ran it by a couple other public adjusters and got varying responses.

    I retain legal counsel for my business and decided to give him a call and posed the question. He is stating that it would flat out be insurance fraud because of your intent. Your intent in this circumstance would be to represent to the insurance company that you are purchasing these items with the intention of keeping them. He stated that they would have a hayday with this if they discovered it. I even posed the question if you were to sell the items on your own and the situation is unchanged.

    Think about it this way – what do you think your insurance company would state if you wrote them a letter ahead of time and told them of your plan? They would immediately reject any claim that you have.

    As I stated before, I think your best approach is to seek for items that are similar to what you are replacing and see if the adjuster would approve those items. Generally adjusters are reasonable if you are being reasonable.

    I know it’s probably not the answer you were hoping to hear.. but I hope it helps in your situation.

  447. December 7th, 2010 at 1:57 pm #Jason

    The initial question is, “If the items weren’t stolen, could you take the items back and return them?”.

    The thing is that insurance is there to make you “whole” again, not to improve your position after a loss. If Patrick was able to get the recoverable depreciation back and then return the items, he would be in a better position than he was prior to the loss. (By having cash in his pocket and no longer in the possession of unneeded items)

    Of course, there is the position that if you replaced the stolen items with new items, you would be in a better position too. But that is a contractual benefit you pay for in your premiums when you get a replacement value policy.

    Public Adjuster, your recommendation is excellent to get the approval from the adjuster prior to replacing any of the items for which he has no need.

  448. December 7th, 2010 at 2:00 pm #Patrick

    Jason,
    I think it’s questionable, hence the reason I asked the question. But if it’s technically not against the rules, then it’s an option I’m considering. My concerns are:

    1. Not breaking the law. If it’s illegal it’s not longer a consideration.
    2. Not triggering an investigation. Certainly don’t need that headache.
    3. Not positioning myself to be “uninsurable”

    Adjuster,
    When you say it’s doubtful it would be found out, please elaborate. Do insurance companies actually follow up on the submitted receipts to see if items were returned (do they have the means and/or capacity to do this??. Truthfully, we were 100% accurate with our claim and replaced 95% of the merchandise. There’s 4 items we just don’t need which is the reason for my inquiry, and in this enconomy the cash value would be far more beneficial. At the end of the day, it’s the same cost to the inurance company if i keep the item or not.

    Thank you both for your responses!

  449. December 7th, 2010 at 2:12 pm #Public Adjuster

    Patrick,

    See my response above if you haven’t already read it.

    Do insurance companies follow up to see if the items are returned?? I’m really not even sure how they would be able to. I mean.. I suppose if they opened an SIU (special investigation unit) and went in and questioned the store – then yes they could. But now you’re getting into hypotheticals and attempting to assess your risk. I can’t really help you with hypotheticals. I’m sure it’s done everyday.. but that doesn’t make it right.

    Although you could use the cash in this economy – you need to realize that if the insurance company discovers that you have committed fraud in one aspect of a claim for any one single item.. they can demand that ALL the money be returned.

  450. December 7th, 2010 at 2:16 pm #Patrick

    I have my answer. Definitely not worth the risk. Thanks again for your input!

  451. December 8th, 2010 at 8:37 pm #deb

    I am insured with Sterling insurance, and we had a water leak in the bathroom that went through the wall into the bedroom. we called a plumber and had the work fixed and called our insurance company, they sent out an adjuster, all seems ok. same day the adjuster was out we found another leak in the adjoining bedroom on the floor. we called out the plumber again and he said he needs to send out a leak detecter and the leak could be coming from under the slab. My question is…is this going to be on the same claim considering the original claim is still not done? and if not and they file it under another claim how will this affect my insurance premiums? I live in Calif. I have tried to call my insurance agent but he is out of the office for the next several days.

  452. December 8th, 2010 at 8:56 pm #Public Adjuster

    Deb,

    The insurance company is going to consider the losses as 2 separate claims since there are two areas that sprung a leak on 2 separate days in two different areas. The question you pose is similar to asking if you had a car accident on one day… and then 10 days later you had another car accident if the insurance company would consider this 1 or 2 claims simply because you had an open and pending claim. They would consider it 2 claims.

    From past experience 2 water damage claims within the same year will most likely trigger the insurance company to refuse to renew your insurance on the anniversary date of your renewal.

    The good news is… there is no shortage of insurance companies out there willing to take your $ to insure your home. You are with Sterling right now.. and in my opinion almost any carrier is an upgrade from them for various reasons. Sterling takes a ton of “forced policies” which means the mortgage company forces this policy on homeowners when they don’t have coverage on their own… or it is part of the overall payment of the mortgage. I don’t know your particular situation but from past experience you shouldn’t lose too much sleep over switching to another carrier.

    Take care

  453. December 8th, 2010 at 9:08 pm #deb

    thank you for your quick response. As for insurance companies we just accpeted this one when we got our mortgage and never checked other companies or rates. So I am sure we will be checking now. I am hoping at least for a good outcome with this incident, as reading some of the other posters issues on here I do consider myself lucky at least at this time.

  454. December 8th, 2010 at 9:39 pm #Public Adjuster

    Deb,

    That’s what I figured about how you were insured with Sterling. That is typical and means you are probably paying too much for what you get. Here in CA Sterling utilizes an estimating program named “Simsol”. It’s the bottom of the barrel of estimating programs in my opinion compared to Xactimate and MSB. So, when they provide you payment make sure you have a min of two contractors provide you bids so you can compare.

    Also remember that the insurance company owes for access to make the repair and repair of the items removed to make the repair but generally not for the repair of the pipe itself. So if it is a slab leak they would owe lets say $750.00 to acess (jackhammer) to get to the leaking pipe.. putting everything back (concrete slab, flooring, paint, etc.) but not the repair of the pipe itself which is usually something minimal like $50 or $100 bucks.

    If you think you have been lowballed by the insurance company then get a public adjuster involved. My experience has been that most insurance companies lowball (or else I wouldn’t even own a successful company in L.A.).. but out of these Sterling is at the bottom. So make sure you get estimates on your own and get a Public Adjuster involved if you feel you are really getting taken advantage of.

    As far as renewing insurance – State Farm requires 3 years claims free. So you can’t go with them. But Mercury should take you on as well as Liberty Mutual. If it was my choice I would go with Mercury since they cover rain water intrusion without having to have a storm created opening like most carriers do and also have “fair rental value” included in the policy which saves a ton of hassle if you are ever displaced from your home.

    Best to you and your family and Happy Holidays

  455. December 17th, 2010 at 12:28 pm #Brian

    I was recently approached by a contractor who is doing a lot of work in my neighborhood here in New Jersey due to a hailstorm. He had me sign a paper stating that he would be doing the work, however there were no dollar amounts filled in. He asked me to contact my insurance company and have their adjuster come out to the home, which I did. The contractor wanted to attend the appointment with the adjuster, to which the adjuster would not agree to (he gave a valid argument in that he didn’t want to have the contractor “sell a claim” to him). Here is my dilemma….I got the insurance company’s contractor’s estimate/scope of services. It lists some charges/services on it that they would do that are on the contract that I signed that the original contractor stated that were my “obligations” (such as contacting the utility services, removing exterior fixtures). The contract states that if he doesn’t do the job there is a $1,500 penalty that I must pay him for time spent (seems to me to be a great hourly rate as he didn’t do anything that day…not even measuring the house!!). First off, am I still obligated to use this contractor rather than the insurance company one? and 2) does the first contractor have to folllow the scope of services exactly as written? My concern is that I don’t have any dollar amounts from this original contractor and they will just do the work taking the entire claim amount for some extra profit!! Thanks.

  456. December 17th, 2010 at 2:37 pm #Public Adjuster

    Brian,

    You probably realized pretty quickly that signing an open ended contract like this is a bad idea. I see a lot of people do this because the contractor convinces them that they will do the work “as per insurance settlement” and since they don’t know what the settlement amount will be, then they can’t put a dollar figure on it.

    To me, that’s a bunch of bologna. If you’re in business its about doing the work right. And in the process you have labor, materials, and overhead and profit of which all are able to be calculated. I never not once as a contractor submitted a bid without the costs being calculated. With insurance claims I didn’t care because I wasn’t going to do the work “as per insurance settlement” but rather do it right!

    The questions you ask are really of a legal nature so I personally can’t answer them. Let me ask you… if the contractor was really doing the work per insurance settlement (which I am making an assumption based on past experience), and the insurance company agreed to replace your roof, siding, light fixtures and some windows… but only wanted to pay $100.00 – would your contractor hold up his end of the agreement? Not a chance!

    I find it very disturbing that your adjuster wouldn’t allow your contractor to be there. Seriously.. who is he to say who you can have on your property? It’s your home. And for him to say that he doesn’t want your contractor to “sell the claim” seems like he is indicating that your contractor would be requesting items that shouldn’t be included. He’s pre-disposed himself. But then he brings his own contractor? So, he is permitted to have someone advise him of the necessary construction activities to properly restore your home.. but you aren’t? A good adjuster would have welcomed a meeting to openly discuss the repairs so he could take care of the damages for you and settle the claim. Although you would have been better served with a public adjuster, you were completely within your rights to have your contractor there and he was out of line to say you couldn’t. It seems to me like he was the one doing the “selling”.

    I would discuss the contract with your contractor. Try to come to resolution on it. He may still be able to assist you to get more money if it is owed to you by providing his estimate. If you can’t come to resolution let him know you are going to discuss the contract with the Contractors Board in New Jersey just to be certain your rights are protected. In all likelihood the issue is going to end there. But maybe not. At least then you will know whether contractors are permitted to utilize these types of open ended contracts in your state. I am almost certain here in CA the contract is not valid until a dollar amount is agreed on.

  457. December 17th, 2010 at 3:04 pm #Brian

    Public Adjustor,

    Thanks for the quick reply. I did do some background based upon the scope of services material amounts and the number that I got back from the insurance company does land in the range that would be within the typical amounts to do the restoration. But my next thought is that this contractor is determining his coat based upon what the insurance company’s builder has put down for their cost. So when I send this scope of services/repair estimates to the “contracted” contractor, does he have to provide me with his scope of services/costs before he can start the job? My concern is that he will take a look at the estimate, and tell me he needs more money, and bot tell me what he needs. By the way, this scenario happened to my next door neighbor. They got the scope/estimate from the insurance company, they forwarded it onto this same builder, and they told them they needed more money to do the job without stating to the homeowner how much more they needed!! I’m thinking at that point, the “contract” is nonlinger valid as they cannot do the job for the amount given and the contract is rescinded. Just trying to cover all my bases as you know first-time property claims are new to us. Thanks again.

  458. December 17th, 2010 at 3:50 pm #Public Adjuster

    Brian,

    You’re welcome. Glad to be able to provide some insight. I understand it’s difficult and you move forward the best you can.

    My opinion as a prior contractor is that this contract would never hold up unless the contractor was willing to keep his end of the bargain. This is where contractors run into big problems because they expect you to keep your end of the agreement but of course their end is ever changing. This is what I was saying was that even though they say they agree to do the work per the insurance company settlement, if the insurance company is only paying $100 – there is no way they would do it.

    A couple years back here in California there was a very well known company doing a similar thing and they got slammed by the CA Department of Insurance. I have known several people in this company for years and several that have moved on and started their own company duplicating this similar process. I always wondered how they could get away with what they were doing. What they would do essentially is do an “as per insurance settlement” contract. They would discuss the damages with the insurance company – and then once the settlement came in if they didn’t do the work they would charge 20%.

    Think about this.. would you rather do X number of homes and make 20% profit (roughly) – or do NONE of the homes and make 20% profit? I’d personally rather not have to undertake the repairs and all the risk and headache of managing employees or sub contractors on top of dealing with client complaints… and still make on average the EXACT same amount.

    Well.. the Department of Insurance agreed and basically stated that this company was essentially acting as public adjusters and they fined them hundreds of thousands of dollars amongst other sanctions.

    Your situation sounds similar. Especially if they are coming back and saying that they need more money. I don’t know if the contract becomes null and void because they ask for more money. But I do know this other company that I speak of would use this tactic just so they didn’t have to do the work… and STILL get their 20%! Some food for thought.

    If the contractor is willing to do the work then his scope would be per the insurance company scope – so he wouldn’t necessarily need to give you a separate scope but rather agree to the scope the insurance company’s contractor outlined.

    Hope this helps – Happy Holidays (from a former South Jersey Native)

  459. December 22nd, 2010 at 12:49 pm #Brian

    Yes it did. I guess I’ll just send the insurance company’s contractor’s scope of services/cost estimate to this contractor and maybe hold him to match the scope line by line as far as services to be provided, sub-contractors needed, etc.

    Happy holidays to you too!! (BTW-Olga’s in Marlton is closed. Getting rid of the 70/73 circle).

  460. January 8th, 2011 at 11:07 pm #Tracy

    My house burned down 6 months ago. My insurance adjuster wrote the check out to me and the contractor (my house was paid in full). I was told by the adjuster to sign the check over to the contractor, which I did (to the tune of well over 100,000.00). Now it seems there will be funds left over from the repairs. Do I get to keep the extra money? The contractor is trying to tell me that I have to pay to repipe some of the house out of my own pocket, yet there is enough money left over to cover that.

    Thanks.

  461. January 9th, 2011 at 10:05 am #Public Adjuster

    Tracy,

    Basically your issue is for the most part to do with your contractor. Although I have no idea why the adjuster would instruct you to sign over the check to the contractor. It should have been just the opposite. The contractor should have signed the check over to you and then you should have paid the contrator progress payments as work went forward. Otherwise you risked the possibility the contractor could 1. take off with the money 2. not complete the proposed work 3. possible delays with little leverage to get the company to move forward. So, that is a very bizarre request of the adjuster to tell you to sign over the check to the contractor.

    Your question of whether you can keep any remaining money is contingent on a few things. So, since I don’t know all the facts I will have to assume that all of the damages have been repaired to your home and all items are back to or better than before. With that in mind the answer would be no. You are not entitled to profit from a loss. The insurance company owes exactly what it costs to repair the home to its pre-loss or better condition. No more – no less.

    I suppose the contractor is telling you that you have to pay to re-pipe part of the house because it was not on the original scope of repairs.

    It’s a little bit difficult to understand your situation because of a few things. 1. Why was there money left over? If the contractor did all the repairs exactly how the scope of work (estimate) was written, it’s odd there would be money left over. Is it because the adjuster just paid the policy limit without any estimate being written? That doesn’t seem to be the reason because you stated you have to pay to “re-pipe” part of the house which means some of the house was still standing. 2. Was the contractor working on what is known as a “cost plus” basis (cost of sub contractors plus 20%) and there just happened to be money left over? 3. What does the contractor plan on doing with the money left over? Giving it back to the insurance company?

    I suppose whatever the reason any money remaining unused should be returned unless the contractor claims he is entitled to this money for additional profit.

  462. January 9th, 2011 at 4:28 pm #Tracy

    Thank you for the response. I will be a bit clearer this time around and maybe it will make more sense.

    I had no clue who to hire to rebuild (partial) my home. Several rooms were torn down and rebuilt from the ground up, but part of the home still stood and was basically gutted with just the walls standing. My insurance adjuster suggested a contractor he uses on a regular basis, so, while still in a state of shock and not knowing what my rights were, I went with him.

    The adjuster cut a check with my name and the contractor’s name on it and told me to sign it over to the contractor for the amount of the estimate (My policy pays full replacement value). Since my house is fully paid for, the contractor took the check, cashed it and has been rebuilding (very slowly), but it should be done soon (next month probably). I have never seen a single bill or receipt for any products or items used to fix my house, though I have asked for them repeatedly. They did finally give me a complete estimate, but it does not total the amount of the check. I tried to contact my adjuster, however he hasn’t bothered returning any of my messages.

    I was told part of the house (that was not rebuilt) should be replumbed, but I had to pay out of pocket for it, yet while the electrician was in there, he tripped over, and broke part of the plumbing. The job site boss actually told me about the sub-contractor breaking the pipes.

    The prices shown on the paperwork they gave me shows highly inflated prices (almost 800.00 more for a bathtub I picked out for 500.00 and they agreed on installing). There are several places like that in the paperwork.

    I have read in other posts here that folks got to keep the rest of the check that wasn’t used. Why is this claim different? I don’t know a lot about insurance and I am trying to understand as best as possible.

    Thank you for your time and patience.

  463. January 9th, 2011 at 4:31 pm #Tracy

    P.S. (forgot this part)
    Oh, and in the beginning, the contractor asked me to pick out stuff like new doors, handles, etc and then turned around and decided I can’t have them, that he would use the old doors in the house (3) and then match the rest of the doors with similar ones.

  464. January 9th, 2011 at 5:17 pm #Public Adjuster

    Tracy,

    I’m not knocking you because I understand that policyholders just put their trust in adjusters and insurance companies. But this situation should stand as a warning to homeowners that suffer losses to make sure that they do their due diligence when hiring contractors whether or not that contractor was recommended by the insurance company or not. I used to HATE recommending contractors when I worked for insurance companies and would stray away from it as much as humanly possible. Even as a public adjuster I still virtually NEVER recommend contractors. Generally only specialty contractors like asbestos or emergency services.

    When the adjuster told you sign over the check to the contractor that just throws up a huge red flag to me. It’s just not prudent in any sense of the term and just leaves you completely vulnerable and at the mercy of a contractor that sounds like he is doing to you exactly what people (insurance companies alike) preach about not falling victim to. I can think of no “good” reason for an adjuster to do that.

    But most of your issues really are contractor/client issues. Not insurance related issues. But yes calling the adjuster and letting him know you’re not getting a fair shake is probably at the bare minimum a good approach.

    Back to whether you can keep the money or not…. in my opinion if your home has been rebuilt 100% pre-loss or better.. and you didn’t participate in any of the re-build… then no. You are not permitted to profit from a loss. You are entitled to be made whole (or better). I’m not sure about the circumstances of the other people that posted here and someone elses opinion. I’m giving my opinion based on numerous other claims with similar fact patterns. Do homeowners keep money leftover from losses? I’m sure they do. That doesn’t make it right in my opinion. Your situation becomes even more unique because you would essentially have to force the contractor.. who knows the adjuster.. to give the “unused portion” of the money back to you. I can’t imagine the insurance company not requesting the money back if that situation ever arose. It would be kind of crummy for them to do so… but…

    But sure.. someone else may have a varying opinion. I recall an inside adjuster for a company back east posting here before. I’d like to hear his opinion.

    And remember, mine is based on you not participating in ANY of the work, coordinating subs, and so forth, and the work being 100% complete putting you back to pre-loss or better I would assume. And you (your contractor) having received the full replacement cost value.

  465. January 10th, 2011 at 10:17 am #Jason

    Tracy and Public Adjuster,
    I read the questions about 6 hours after they were posted and stayed away from this scenario. There was not sufficient information to answer the questions and now with the additional information about the adjuster recommending the contractor and the adjuster indicating you should sign the check over to the contractor is completely backwards.

    Public Adjuster is correct that you do not control the work, it’s timeline, or the funds when the contractor already has the money. A contractor should be paid partially for the work before it is completed and money should be held back as an incentive to complete the work in a timely and appropriate fashion.

    As far as money left over from this claim, I don’t see any money left over and I don’t think you will either. So the question about do you get to keep any left-over money is immaterial because there is no left-over money.

    You probably need to involve the adjuster and perhaps the adjuster’s manager or supervisor on this one. You should be the one involved in payment of the work as it’s completed. Your example of the incorrect tub and existing doors and hardware being installed is one of the obvious reasons why the contractor should not have the rebuilding funds with absolutely no checks and balances.

  466. January 19th, 2011 at 8:47 pm #deb

    I recently asked a question about filing insurance claim and you were very quick and accurate with your response. I now have another question I hope you can help me with.
    I had 2 seperate bathroom leaks, both of which an adjustor was out and my insurance company sent me a checks for the repairs. The problem I am having is that the insurance agent said he won’t accept the bill from the plumber because it is not itimized, it states in detail what was done but not broken down. I have called the plumber several times and so far he has not sent me any breakdown. the plumber is licensed and had good standing with the BBB. My question is twofold, any advice on how to get the plumber motivated and does the insurance company need a fully itimized bill?
    thanks

  467. January 19th, 2011 at 9:13 pm #Public Adjuster

    Deb,

    If I understand your loss correctly its a pipe break or leak. The insurance company claims they owe for “access” to the pipe but not the pipe itself. So to answer your questions; 1. That’s pretty lame of your plumber not to help you out. Call him again and just ask him kindly you are trying to get reimbursed and need his help. Remind him that you promptly paid him and would love to continue to refer him… 🙂 2. No the insurance company does not need the bill broken out. It’s not like they haven’t been around the block before… they have been faced with this situation hundreds of times. So, they know what it costs to gain access, and what it costs to make the repair itself. I would tell the adjuster exactly that. It costs about $50.00 to make the actual repair to the pipe. That’s it. The rest is to gain access to the pipe whether it’s a slab leak, shower stem valve leak, or whatever… it’s about $50… no more than $100. Everything else should be paid under the policy. Tell the adjuster your situation and tell him to make a reasonable reimbursement and close his claim. A closed claim.. is a good claim. As an inside adjuster I did this every day of the week. I’d call the plumber up and get a verbal on what the charges were… close the claim and move on. It’s that simple and it’s a shame you have to get an adjuster that doesn’t want to pick up the phone. If that doesn’t work try a 3 way call with the adjuster and plumber and get a verbal over the phone explaining the charges. Just be persistent.. I’m confident you will get it resolved!

  468. January 19th, 2011 at 9:31 pm #deb

    wow thank you SO much for your advice. The problem was a slab leak and quite pricey, when the plumber left he told me if the insurance company had any questions to call them. When I told our agent he said it was not his job to pick up the phone and call anybody so please have the plumber itimize the bill. I have the detailed written statement and can email it to the adjuster at any time if he will accept it. I have called the plumber 3 times in 6 weeks and have been more than polite about this but at this time I am just wanting to get it over and done with. Your advice has given me the courage to just move forward and hopefully everything will work out.
    thank you very much.

  469. January 19th, 2011 at 9:56 pm #Public Adjuster

    Deb,

    You’re welcome. I am truly offended at your agents response and lack of service to you. That’s just sick. Take your hard earned money and business elsewhere. This agent does not deserve your loyal business.

    With a slab leak nearly everything is gaining access to make the repair.. and then of course repairing the slab itself. The pipe repair is nothing compared to the overall bill. Like I said – $50 – $100.00. You should have no issue. Get your money.. what you deserve.

    If you need more assistance just write back. But I think you’ll be fine and get your money back.

    Take care

  470. February 7th, 2011 at 4:39 pm #Autumn

    My Apartment building had an electrical fire. When I signed up I was never asked if I was selling my apartment building at the time I signed up I was looking into to selling it b/c of being robbed and a few other things. Part way through my sign up they asked some questions I didn’t know the answer to so I gave the phone to my fiance they told us it would be better to add him even though that was not my plan. He believes he was not asked about the house being sold but I am sure I was not. I was never sent any paperwork just given a policy. Being the owner of the apartment building I feel I should of been asked this b/c my fiance is now saying I may be denied my claim about the fire due to me trying to sell the house. I have no mortgage and I am a first time home owner ( I live in the apartment building this is the building/house I own) so I did not exactly know what I was doing. Should I have been asked about selling when I signed up? Will I get denied due to the fact I was never even asked the question? I already made my claim. I may have lost up to 85% of my house I need help… I am covered through Allstate

  471. February 7th, 2011 at 5:29 pm #Public Adjuster

    Autumn,

    Given the situation and suffering a devestating loss I can understand your extreme concern. But I think you’re overly concerned and worried about an issue that really has to do with underwriting (whether they would approve you for a policy or not). Obviously Allstate issued the policy and you didn’t lie on the application for insurance. So its a non-issue. I know of no exclusion in the policy that does not allow you to sell your home within 12 months or something like that. Don’t worry. Just focus in on getting your life back together.

    Since it’s such a large loss you should consider hiring a public adjuster to provide proper guidance and deal with the insurance company directly. It would take a huge load of stress off of you and you will know for certain you are getting all you are entitled to. Go with someone you are comfortable with, has a solid reputation, and solid references.

    Take care

  472. February 7th, 2011 at 6:31 pm #Jason

    Autumn,
    You asked if should you have been asked about selling your property at the time of application. That answer is yes. That is a fairly common question on an application for insurance.

    It would not make any sense if you were denied because you didn’t answer a question about your intent to sell your property or not. That would not be a viable reason for denial. So the answer to that question about you being denied for not being asked that question is no.

  473. February 17th, 2011 at 12:21 pm #SEAN

    We had water damage on our 1st floor laminate and the insurance will cover the replacement. We also have a leaking pipe from the 2nd floor bath and has ruined the 1st floor ceiling and a part of the wall on the 1st floor. I reported the leaking pipe to the insurance and they said they will not cover the damage the pipe caused because it is not a “sudden and accidental” occurence.

    The check the insurance gave me is more than enough to fix the flooring and to fix the leak and the damage ceiling and wall. There will be a little extra left over from the check. Can I keep that $ or do I have to return it to the insurance? How can I show them a receipt if I only have one contractor to do both jobs? The adjuster wants a copy of a receipt and pictures that the repair was actually made. I was planning to repair only the flooring that buckled and not the whole area, so that I can have the leak fix, like put tiles on the area that buckled since it is the kitchen area and leave the rest of the floor as it is. Will the adjuster have a problem with this? I am also trying to get back the holdback money they took off.

    The contractor said it will take him 2-3 days for the job, do I claim ALE with the insurance? since on the estimate they will be painting the whole house and fix the kitchen floor so we won’t have access to the kitchen for 2-3 days.

  474. February 17th, 2011 at 2:35 pm #Public Adjuster

    Sean,

    You don’t have to return the money and you are entitled to do whatever you wish with your home. If you want to put in tile then put in tile. If you want to make a repair to the ceiling then make a repair.

    However, if you are attempting to get the recoverable depreciation back then you will need to make repairs that cost as much or more than the adjusters estimate. Ex. if the adjuster paid $10K .. withheld $1K and you spend $8K – then the insurance company would not owe you. As long as you spend more than whatever the check was they will owe the balance assuming you are not including the areas not covered.

    As for ALE – whatever the time frame related to not having a kitchen due to the covered damages would be the time frame you can submit for ALE. If you are doing extra work then do not include that time frame.

    Hope this helps.

  475. February 26th, 2011 at 7:25 pm #Dee

    Hello, I just had a fire at my rental property. The kitchen was totallydestoyed. Smoke damage is present throughout the house. I am waiting for the adjustor to submit me a estimte or scope of work for the damages. This property is in Detroit. I have heard lostof things about claims. I have replacement cost, and loss of business,insured for slightly over 100k.
    I have a senario that I am confused about. If the Insurnance Company decides the cost to repair replace is too expensive and they decide to give me cash value of lets say 75K. My mortagage is 45k. What happens to the 30K???? Does it go to me or the bank. The house is actually collaterol for a business loan with my company?

  476. February 26th, 2011 at 8:21 pm #Jason

    Dee,
    The “what if” scenarios are difficult to address because there are so many variables that could happen and we don’t have all the information to make those assessments.

    Now, in your case, you have a kitchen that is totally destroyed and the rest of the property has extensive smoke damage. If the insurance company determines that the cost to repair is $75,000. then your mortgagee would be included in the check to you and it is expected that you would make the repairs to the property. Do you have to make the repairs? No, but then you would need to pay off the mortgage and the remaining funds would belong to you.

    If the property is repairable, then repairing it would probably be the reasonable thing to do especially if you have a replacement value policy. The insurance company would use new materials and use current labor costs to repair the property.

    When it makes sense to not repair is if it is a total loss and you have no incentive to repair the damaged property. The property will still belong to you so what will you do with a piece of property that you still are required to pay taxes upon and maintain it (snow removal, etc)?

    Now, your last question is technically a legal question but I am going to answer it to a degree. The business loan is really another lien on the property to ensure that you repay the business loan. Is it a true lien? No, not really but it could be in the event the bank wanted to enforce the collateral arrangement if you defaulted on that obligation. So, a quick and simple answer is that the $30,000 you referred to would go to you. You are the next party in line for it and your bank that did the business loan is not in that capacity right now.

  477. February 27th, 2011 at 4:00 am #dee

    Actually the business loan is the only lien I have on the investment property. The estimated expenses seem to be from 50k to 100k. I heard that you can rebuild somewhere else which seems like a better choice. I guess I should pay bank off first before negotiatin.g with insurance co. I don’t have any prepayment penalties fees. The real question is th Amount of the cash value. Is more than the mortgage will the ins. Co. Cut. The bank and me one check and I have to fight with the bank for my change. Or will the ins. Co. Write. 2 checks one for amount of balance the other 2 me left after amount.

  478. February 27th, 2011 at 6:33 am #Jason

    Dee,
    Those concerns are very valid that you have. The best way to learn the answers is to talk directly to your claim handler and ask him questions and express you concerns to him.

    I am not certain you can build elsewhere because I have not researched that option in Michigan. That may be something an attorney can address with you.

  479. March 11th, 2011 at 2:22 pm #Ally

    I had a house fire I was told that day it was an Electrical fire and the House was turned back over to me that afternoon. I got the fire report it stated it was an electrial fire, no human involvment, no arson, etc. 4 days after the fire I got a call that the personal property and fire investigator from the insurance co. were at my house, I had a clean up Co. there so they let them in. The following day I got a call that the police were there, I was confused. My clean up crew told me that the Fire investigator from the insurance co went back in the house the following day.. 5 days after the fire took stuff from the house went outside and called the police to turn over stuff. The police are telling me that they never went in my house even though my neighbor said they were there for a few hours. I called the city law department to get a police report because I wanted to know what the insurance co took and handed over to them, I was told by the city law department that there was no police report because there were no findings and that it seems just like it has been blow out of proportion. What I want to know is can an insurance co. do this? Go in your house take whatever they want call the police and just hand whatever they want over I dont know the laws so I dont know what is legel and what isnt. Thanks

  480. March 11th, 2011 at 2:30 pm #Ally Ann Hert

    my question got posted twice sorry

  481. March 11th, 2011 at 2:49 pm #Jason

    Ally,
    Sure, the insurance company can investigate any claim made. Can they call the police? Sure they can. Can they hand over things to the police? Sure, they can. Is this the most appropriate way to handle a fire investigation? Probably not. Not only did you endure a house fire, but you seem to be facing some miscommunication involving the entire claim process. If there is a fire investigator hired to investigate the cause and origin of the fire, then you should be fully aware of their involvement. And that investigator should be involving you in their process (to a certain point) that involves respect and adequate communication.

  482. March 12th, 2011 at 6:18 am #Ally Ann Hert

    Jason,
    The orgin has already be determined I found out yesterday as a light but the stuff they took does not even really pertain to the fire. There was no communication with the insurance co to me that they were even coming back that. PLus the house was turned back over to me and the scence was no scured so to come take my property out of my house without contacting me doesnt seem right.

  483. March 12th, 2011 at 6:23 am #Ally Ann Hert

    Not secured*

  484. March 12th, 2011 at 6:49 am #Jason

    Ally,
    It doesn’t seem right but what do you want to do about it? It seems there was a lack of communication. You seem to know what stuff was removed if you are aware it doesn’t pertain to the fire. You know more about your situation than I do and you’ll just have to move forward. It doesn’t make sense to dwell on this situation.

  485. March 12th, 2011 at 2:18 pm #Ally Ann Hert

    jason thank you I understand it is just frustrating that insurance companies can come and do what they want. thank you for your help

  486. March 28th, 2011 at 7:33 am #Kari

    I am seeking some help. I am insured with Travelers on an HO3 contract. We received our water bill that noted a potential leak. We immediately called the plumber out who confirmed a hot water slab leak. He installed shut off valves, and provided an estimate….a huge estimate. They informed me that insurance covers this. So after questioning others, underwriters, agents etc, they were all on the fence. (I’m an agent that actually sold this to myself….) I don’t handle claims, and this isn’t so black and white, so I was unsure. I filed my claim last week. The adjuster came out and immediately denied the claim stating “I am not able to locate any coverage for this in your contract.” OK, then point to me where its excluded…he said its not excluded, but since I haven’t suffered a direct physical loss by a covered peril, as we stopped the water from going everywhere, by having the valves installed, we didn’t have a loss. So I ask my husband what the adjuster did and he said nothing. I asked if he saw the warped baseboard behind the water heater and he said no, he didn’t look. So the next day I called his manage, advised that I actually sell his product daily, and am quite upset. He appeared very understanding and said we’d get a new adjuster and they would pay for the “investigation”. So a restoration company and another plumber will be out tomorrow to report their findings. Do I have any hope in having this covered? Like my uninsurance saavy husband says, how do they know we don’t have damage to our home without looking at the slab, interior dry wall, under floor etc? The plumber seems to think there damage and even told the adjuster that if he didn’t do the valves there would be.massive damage. Any advise you can spare would be.great. thanks.

  487. March 28th, 2011 at 8:04 am #Public Adjuster

    Kari,

    You have suffered a very common loss. As an agent I can tell that you are aware that you have an All Risk Policy – so you are looking for the “exclusion”. There are a couple of exclusions – one which may surprise you.. which is water. That’s right.. water damage is excluded.. UNLESS.. there is a “sudden and accidental” discharge of water from within a plumbing, heating, or air conditioning system or a named peril caused damage to your home allowing water to enter in. Then, the ensuing water damage would be covered, but they do not cover the part or appliance from which the water escaped. However, if it was sudden and accidental AND caused damage to the structure, then Travelers would owe for access to the pipe and repair of the areas accessed – but not for the pipe itself. The pipe is excluded from repair under the “wear, tear, deterioration” exclusion.

    This is what I see you are going to face with the inspection. 1. You stated that you were alerted to a leak due to a high water bill. That might be an issue. Water damage will more than likely be denied if the pipe has been leaking over a period of time. The carriers consider this to be more than a week – whether you knew about it or not. So, they are going to look at when the bill arrived, how long you took to do something about it, etc. 2. Are you able to attribute the interior damages to the burst pipe in the slab? In other words is the warped baseboard behind the water heater attributable to the slab – is it in close proximity?

    I think what the adjuster might have been thinking was that if the pipe that was leaking didn’t cause any damage to the structure then you have not suffered a direct physical loss to be able cover in the first place. Keep in mind that the pipe itself is not covered.

    Now, if coverage is extended then go back to what should be paid for. Any interior damages, access to the slab pipe (tearing out flooring, slab) and then putting back the flooring and slab, base, drywall, painting, and so forth. Technically the insurance company would still owe for the flooring even though you chose to re-route or bypass the leak somehow. But, at the very least you should be able to get them to pay for the re-route in lieu of the flooring.

    Remember, sudden and accidental – the pipe needed to be causing damage to the structure.. for a very short period of time.

    I hope this helps. Let me know if you need additional info.

  488. March 28th, 2011 at 8:24 am #Jason

    Kari,
    With a H03, there is coverage for everything unless it is excluded (generally). From what you posted, I fail to see damage. If there is a leak within your slab, that falls under the category of maintenance and the homeowner should repair it as routine maintenance.

    Many insurance companies will take the approach of covering the cost to to get to the leaking plumbing to determine if the leak occurred from a covered loss. This might be the best approach for an insured because this investigative action can be more costly than the actual plumbing repair itself.

    You can’t really take the approach that if you didn’t do the valves that there would be massive damage because you DID do the valves and there is not any major damage. An insured must do what is reasonable and necessary to prevent or reduce damage.

    Warped baseboard likely would be covered. Concrete that becomes wet is not damaged. Perhaps the best approach would be for the insurance company to expose the damaged plumbing to see if it’s covered. Some insurance companies will not cover the repair to the plumbing (maintenance or not covered damage) and then covering the pipe again to the condition before the area was exposed.

  489. March 28th, 2011 at 8:25 am #Kari

    Thanks! The restoration company just left, and took pictures of the damaged base boards- We actually read the policy word for word (as an insurance agent myself, I was blown away- and can’t imagine how some one who didn’t know insurance would feel…) And yes, the “sudden and accidental” is what may get us. But then again, I’ll keep arguing, and that any “normal” person wouldn’t know they needed to look under their slab. The baseboard wasn’t damaged prior to the notice. I am okay with paying for the repair to the pipe ( the plumber today said he would cap both lines off and lay new lines to stop any other leaks from happening) and only would have to tunnel the foyer. I feel like we should have just let the water destroy our floor and not abide by the insurance contract and stop any further damage from happening… But being an agent I can’t, nor would I ever do that. I don’t want to damage my home. But that seems to be the damage they were looking for. So we’ll see. I called the claims manager, and left the restoration companies phone number on his voice mail, because quite honestly, I am not sure what my roll is at this point. I mean, we had the plumber (times 2) out, diagnosis was the same- restoration company out, took pictures of damage- I don’t feel like being the middle man– so hopefully they will communicate and see whats going to be covered… if anything. Interestingly, Auto-Owners just paid this exact claim (client had little hot water- have always thought it to be a bad hot water heater- called American Home Shield to repair is under the home warranty, and the tech advised them it wasn’t the hot water heater, but most likely a slab leak) no visable damage- but they covered it. I’m not familiar with their contract, but I am pretty sure the “average” Ho3 covers/excludes the same… What a crazy week it’s been!

  490. March 28th, 2011 at 8:26 am #Kari

    Sorry, let me add- the home was closed on NEW 12/09/2002- so it’s a new home.

  491. March 28th, 2011 at 8:33 am #Kari

    Jason- They told me that I could (on my dime) have the pipe exposed and see if it would be a covered loss. (this was before I spoke with the claims manager- this is what the first adjuster said) We’ll see. Thank you for all of the input! Like I said. My concern would be if they paid to “investigate” the cause and dug up that pipe, I wouldn’t be in a position to lay put my house back together if they don’t find any loss. Therefore leaving a hole in my floor and a pipe that is exposed.

  492. March 28th, 2011 at 8:44 am #Jason

    Kari,
    With an all-risks policy, it’s the insurance company’s obligation to to “prove” exclusion. The all-risks policy provides coverage unless it’s excluded so you have coverage unless and until the insurance company proves it’s not covered with an exclusion. So, it would be the insurance companies cost to determine if the leak to the pipe is a covered loss. (Most cases it’s not but there may be some circumstances that the damage to the pipe may be covered). There is a cost to get to the pipe and that cost is also the cost of covering it back the way it was before they opened it the hole. The insurance company needs to restore the destructive investigation activities they do while inspecting a claim.

  493. March 28th, 2011 at 12:22 pm #MJ

    My home, Insured by ERIE insurance for 19 years, burned down last year and was a total loss. My policy states ERIE would increase my insurance every year to keep up with inflation and construction costs. The upper limits of my policy was $100,000. A friend who is a contractor did a cost estimator says the replacement cost for the home would be $160,000. ERIE did not increase the Insurance enought to keep up with inflation and construction costs. My insurance agent told me they were only responsible to keep my homeowners insurance at 80% of it’s reconstruction cost and they were under no obligation to tell me. It does not say this anywhere in my policy. He told me that was the law but he would not provide any proof this is the law. I submitted a proof of loss to my adjuster (at his request) for $160,000. He called me and told me I was only allowed to claim the limits of my policy on the proof of loss or $100,000 and returned it to me to be “corrected.”

    Also, I work approximately 80 miles from my home and rent a sleeping room for $100.00 per month (from an elderly man) so that I do not have to drive home when the weather is bad. My adjuster told me they would not pay rent for a home because I had a place to stay. I told him this was only a sleeping room and I had no place to put any of my things that I would be replacing. He told me that was not his problem. He may pay for a motel room in my hometown for the nights I returned but only after I submitted the bill. A motel room is about $90 per night which I can not afford to pay on a regular basis until my home is rebuilt.

    I can’t afford a lawyer. What do I do?

  494. March 28th, 2011 at 12:50 pm #Jason

    MJ,
    The information you provided may not be based on accurate information. If you had your home insured for 19 years and it’s adjusted insured value is $100,000 now, it must have been insured for an amount considerably lower 19 years ago. The adjustment insurance companies do per year is fairly accurate so that means your coverage may have been lacking for 19 years.

    But, that is not where it ends. You said your friend who is a contractor did a cost estimator based on this house. If a house that was insured correctly 19 years ago and adjusted for increases in inflation and construction costs, the valuation should be closer to $100,000 than $160,000. I am at a loss because I don’t have all the information about your house.

    Your adjuster likely has his own cost estimator based on your house. You may want to ask him for a copy of that so you may make an informed proof of loss claim. As for claiming only your limits of your policy, that is not correct. You can claim any amount you want. The policy coverage limits happen to be the insurance company’s limiting parameters, not yours. For example, if you make a claim for $1 million dollars, they can accept that and pay policy limits, which happen to be $100,000.

    Also, if your house is insured to 80% of it’s replacement cost, your policy should have written into it an allowance for 20% more than your insured value if the cost of replacement exceeds your insured value. This is assuming your policy is a standard HO-003 policy.

    As far as the sleeping room, that seems to be out of the additional living expense parameters. It really has to make sense for the policy to be able to cover it. If you don’t have the funds for $90/night, work with your insurance company in order that they provide you with a cash advance for those expenses or for the hotel to send the insurance company a direct bill for your additional living expenses.

  495. March 28th, 2011 at 7:07 pm #kari

    Jason,
    thanks for clearing that up. That’s what I thought, but I felt like they didn’t want to be overly clear in their explanation. I understand the pipe isnt covered. My concern is the broken pipe caused unseen damage and the first adjuster basically said because they can’t visibility see anything right now, there was a loss. We argue that there may be damage to drywall etc that can’t be seen until floors are pulled up etc. Seems silly that they would pay to dig the pipe, bust the foundation, make repairs to the foundation that they worked on, new carpet, floor etc and deny it. They would be doing exaclty what I think they should. Aside from fixing the pipe- but I know we have to fix that. Water is such a gray area. I think you asked about the location of the baseboards….they are right behind the water heater. Thanks again. Ill be anxious to here the outcome…hopefully prior to Friday as we are leaving on vacation.

  496. April 3rd, 2011 at 8:30 pm #Chuck Herbel

    Has anyone taken out an insurance policy on a property located at 9821
    Sadie Ave ,St Louis, Mo 63125-2757 in the 2007 – 2008 time frame.because
    we are the Mortgage holders on said property. Occupants. no forwarding
    address.

  497. April 3rd, 2011 at 8:53 pm #Chuck Herbel

    to add to comment 496
    unknown fire caused total destruction of property,. and fire damage not
    only destroyed this property but also incurred many thousands of dollars
    to neighboring houses.
    Fire department report confirms extensive fire damage.

  498. April 5th, 2011 at 5:00 pm #Dennis Johnson

    We had a house fire recently when my microwave caught on fire while heating up some chicken.

    We own a three bedroom townhouse.

    The majority of the damage was from smoke and from water from the fire department making sure there was no fire in the walls.

    We have been put up at a nice local hotel in two connecting rooms (Myself, Wife, three young children).

    We are now being moved to a rental home in the area. We said no to the first place which was in a bad drug infested neighborhood.

    The second place we are being sent to this week will be a one bedroom apartment. (it has a living room and a den where the kids could sleep) but I am wondering….

    What type of replacement living accommodations is to be expected? How much should I push for something equal to my house?

    We have no timetable to get back to our own home. It’s been two weeks already and at least a month more as no work on fixing the walls, floors etc etc has even been started yet.

    Is there anything else I should be aware of that could help me make sure I don’t get abused by the system? I am really naive about what is normal and what to expect from the insurance company. I have a fairly nice townhouse but with three children and with work being scarce (I work days, my wife works nights) it’s stressful right now living without our stuff or in our home.

    We are very grateful that we have insurance and do not want to be greedy and push for more than normal but I am very much aware that an insurance company is looking out for themselves primarily and I’d like some help in knowing how to look out for my family.

    Thank you very much in advance for any help anyone can give.

    PS) We have State Farm insurance and honestly they have been helpful and nice but we have had to push a little to get a 2nd motel room and we had to push not to be placed in such a bad neighborhood. I just don’t want to push too much and maybe have it backfire on me.

  499. April 5th, 2011 at 7:05 pm #Public Adjuster

    Dennis,

    State Farm has always been one of the more reasonable insurance companies that I have represented clients for. Not all have the same experience but my experience is that their adjusters are trained better than most, have a stronger interest in caring for insureds, and many I know have been with the company 20+ years which says a lot in this industry. That being said, I have had issues very similar to yours that needed to be resolved.

    Assuming you have adequate coverage for additional living expenses, you are not being treated anywhere remotely close to fair in your situation. You have a great attitude, one that insurance companies love, but in order to benefit from your policy you are going to need to tweak your thinking just a bit.

    Your insurance policy is a contractual obligation wherein you agree to perform certain duties and your insurance company also agrees to perform certain duties if you suffer a covered loss. I often tell my clients to “re-think” of this to be akin to a contract you have with a general contractor that is putting a second story on your home.

    While building the second story, the contractor gets all the framing, electrical, plumbing done and installs the drywall… at what point do you say “well.. I don’t want to push too hard to have him finish because I don’t want it to backfire on me”? Would you ever say after you paid him… “you know.. don’t worry… I’ll finish putting in the cabinets, flooring and paint ’cause I don’t want to take advantage of you”? You don’t!

    And you shouldn’t with your insurance policy. You paid your premiums as agreed so you should expect to receive every single thing that you are entitled to under the contractual agreement (policy).

    What are you entitled to? Well, almost all policies state something to the effect “we pay for Additional Living Expenses so that you can maintain your normal standard of living”.

    Your normal standard of living is a 3 bedroom townhome in a community that has certain characteristics (close to school, church, work, etc.). So that is what you are entitled to under the contract. A one bedroom apartment does not represent “your normal standard of living” and does not fulfill the contractual obligation of the insurance company.

    You of course cannot have the same home, same neighborhood etc. But you are entitled to something similar in a nearby area if that is available.

    What should you do? You should call the adjuster and explain that it seems unreasonable and is causing you hardship to live in a 1 bedroom apartment. Ask the adjuster what you are entitled to under the policy. If the adjusters cannot answer, will not answer, or does not give you a reasonably satisfactory answer for the reason they have stuffed you in a one bedroom apartment, ask to speak to the supervisor.

    I’m confident though that once you ask what you are entitled to, the adjuster will answer you correctly, and then you can ask if he(she) would like to assist you to find a place (they have housing relocation companies on their vendor list) – or if he/she prefers you find something of like, kind and quality on your own.

    Keep you chin up… you should not have any problems getting what you are entitled to. You’re not pushing too hard and there is nothing to backfire on you anymore than if you asked the contractor to finish the 2nd story of your home that you agreed to with him.

    Let me know how it goes and if there is anything else I can help with.

    Take care

  500. April 5th, 2011 at 8:13 pm #Jason

    Dennis,
    The normal standard of living is big. I agree with public adjuster that the 1 bedroom is not sufficient if you were in a 3 bedroom. These arrangements will be inconvenient but it should not be unbearable for you.

    Open communication with your adjuster is important. Ask questions and if it doesn’t sit well with you, speak to their manager.

    Also, you are entitled to a normal standard of living in regard to other things such as electricity, cable, etc. If you have to pay for utility hookups, save your receipts because costs that you incur because you are displaced from your home are reimbursable to you.

    A good thing to do is to save all your receipts during your entire time you are out of your place in case you may want to be reimbursed for something that you were not aware was allowed. It is common that people have more food related expenses because they have to eat out rather than eating in because all the spices, cooking utensils, food supplies are not available at your temporary residence. Check with your adjuster about what is acceptable in regard to this.

  501. April 6th, 2011 at 8:56 pm #Messed UP!

    My husband and I unknowingly bought a nightmare of a house in August of 2007…previous rental property (in TN owner’s of rental property don’t have to disclose anything that they know is wrong), bad real estate agent, bad inspection, bad advice, BAD timing. We had previous termite damage that the previous owner had “fixed” with two loose cinder blocks and some loose 2x4s stacked on top of one another holding up the floor in our son’s BR that the home inspector “missed”. When the floor started to buckle, my husband found the damage and we contacted our insurance company and while they were out I also noted that the floor in our kitchen had started sagging. Of course, the insurance wouldn’t cover the BR floor because of termite damage and pre-existing condition. And the adjustor said that he didn’t see any water damage to the kitchen floor. He thought it was the weight and positioning of our new frig.

    A couple of months later, I started to straighten up under the sink and picked up a bottle of jet dry in our “cleaner bucket” and noticed it was wet. After further investigation, the entire bottom of the cabinet was wet, but had been hidden under mesh lining and our cleaner bucket. The water had been leaking into the bucket which had tiny holes that would then leak onto the bottom of the hardwood cabinet. The mesh was protecting the rest of the items in the cabinet. We had cardboard boxes under the cabinet that were dry as a bone.

    Our insurance policy says that slow leaks are covered if they are hidden in the walls. Would under the cabinet in had a hidden leak under our kitchen sink in the base cabinet?

  502. April 7th, 2011 at 6:54 am #Jason

    Messed Up,
    This sounds like a bad investment and one that you may want to extract yourself from.

    The leak under your sink is no longer hidden. You did not indicate there was any damage from the leak, which if there was, it is probably minimal. The remedy is to stop the leak, dry the cabinet and move on.

  503. April 7th, 2011 at 5:50 pm #Messed UP!

    We never would have bought the house if we had known about the problems that were missed by the inspection. And now we are stuck in it.

    The leak has been unknowingly going on for some time and has resulted in damage to the cabinet and adjacent cabinet, and more frightening, the subfloor. This is why the floor started to dip.

    What do you think should the insurance cover this?

  504. April 8th, 2011 at 5:11 pm #Jason

    Messed Up,
    The insurance company doesn’t help you with your business decisions regardless if they are good or bad. They address direct damage as the result of an incident that is not otherwise excluded. In your case, The policy WILL provide coverage for mold, fungus or wet rot if the damage is hidden in the home’s walls, ceilings or floors. However, the hidden damage has to be due to the accidental discharge or overflow of water or steam from a plumbing or air conditioning system, a household appliance, or a fire sprinkler system. Coverage for hidden damage from accidental discharge and overflow also exists when caused by several sources located away from the residence premises, such as storm drains, water pipes, steam pipes, or sewer lines.

    Now, the way you describe the water intrusion, it seems there could be coverage up to this point. If your policy contains the previous wording, it likely also covers this additional wording which is very important since there is a loss that is already in play that is not covered.

    EXCLUSIONS—SECTION I
    This section is of extreme importance in determining if something is covered or excluded. “Is this covered by my policy?” One of the places an an adjuster looks is in the Exclusions section of the policy. There is no insurance protection for either direct or indirect loss that is due to any of the sources of loss that appear in this policy section. The loss is excluded:
    -regardless of any other cause or event contributing concurrently or in any sequence to the loss, and
    -regardless of whether the damage is localized or widespread.

    An exclusion will trump any coverage if they happen at the same time or around the same time and the excluded item, event, or occurrence causes any part of the loss.

    Adjusting a loss cannot be done without examining the loss, gathering the information, and applying it to the policy. This information is only my opinion of what may be the result of your claim. I am not the person who determines if coverage applies from your policy based what you have explained and you may not know the answer unless you file a claim, and investigation is completed, and a determination is made.

    I am not aware if there is any termite damage to the cabinets and whether the cabinet water damage will or will not be concurrent with the termite damage. I won’t know unless was able to examine the claim personally.

    So, in direct response to your question, “Do I think the insurance policy will cover this?” I do not know, and I believe I’ve provided information why this is difficult to determine without actually inspecting the claim.

  505. April 11th, 2011 at 5:35 pm #Alaine

    My father in law had commited suicide by gun shot and we were advised to have a trauma clean up company clean up the blood. The work was done on a weekend and the insurance company was not able to be verified until Monday for coverage. The insurance said it was not covered and the cleaning company feels that we should dispute the issue because other insurance companies pay with similar policies. The insurance said there are “named perils” which only include fire, lightning, internal explosion and a few others (unrelated). I found an article that said “shooting” is not a named peril but “explosion” is thus providing cause of loss. If the insurance still disagrees and denies what can be done before investing in an attorney. Is there anything that I can say or do to get coverage? If I get an attorney what is the chance I will win?

  506. April 11th, 2011 at 6:35 pm #Jason

    Alaine,
    Sorry about your loss. The cleanup needed to be done regardless, and now someone has to pay for it. The way you indicated the policy provides for coverage is a named peril basis. The other option for a policy is an all-risks policy which covers everything, unless the cause of loss is excluded.

    A named peril policy covers 9 or 10 listed perils and explosion is one of them. The burden with a named perils policy is that the insured needs to prove coverage before coverage applies. In an all-risks policy, it is assumed that coverage exists unless proven by the insurance company that is does not.

    If the cleaning company advises you to dispute this with your insurance company, they may be able to assist you with your approach to getting this covered. Trauma cleanup is generally expensive and is commonly paid by insurance.

    I am sure coverage has been provided under the peril of explosion in cases very similar to yours even under named perils policies but I have not verified this. I have not reviewed any case law in any states to confirm this. I am not an attorney either so my interpretation of the law is not the same as you would receive from an attorney.

    Make attempts to work with your insurance company (and the trauma clean up company) to see if you can get the insurance company to cover this as explosion.

    As far as coverage, the trauma clean up company can probably provide you with better information than I can because they encounter it more than I do.

    If you get an attorney, I don’t know what the chances of success for you would be.

  507. April 12th, 2011 at 6:33 pm #Messed UP!

    Thank you for your clear explanation. The insurance company informed me today that it will be covered. We were denied initially, so I am relieved!

  508. April 12th, 2011 at 6:47 pm #Jason

    Messed up,
    I have empathy for the customers who have to battle with large insurance companies and you seem to be in the middle of a battle. I hope it works out for you. It is true that the squeaky wheel gets the grease. Sometimes paying a claim is easier that denying it. I don’t know what they are covering, do you? Will they cover the flooring, the cabinets, or what?

  509. April 15th, 2011 at 10:20 am #Jackie

    I have a State Farm homeowners policy. My refrigerator leaked under it on the floor, damaging the floor and the neighboring wall. I believe it may have been from the icemaker. Would this be covered?
    Thank you.

  510. April 15th, 2011 at 10:24 am #Jason

    Jackie,
    From your brief description, yes, this would be covered.

  511. April 19th, 2011 at 1:33 pm #Dennis C

    In discussing my personal asset coverage with a possible homeowners agent for my property we were discussing coverage amounts and the claims process if one was ever needed to be filed. I was told that if I have replacement cost on my personal property and I have to file a claim I would not have to provide a list of what was lost, since they use a percentage of the coverage amount. It just doesn’t make sense to me not to provide a list on what was lost. I don’t see an insurance carrier taking out there check book and writing a check say $75K because that is what I said I had lost. They also said they have never had a claim denied due to lack of supporting information (i.e. receipts, pics, etc.)

    I am leery of this because I would think that the insurance carrier would want a complete itemized list to insure that they were not paying more than required even if I had $300K in personal coverage. I am keeping a record regardless of all my assets to make sure if I ever had a claim I would be protected. But for my own reference can you explain how having replacement costs coverage prevents me the insured from having to provide info to the carrier in the event of a loss, and how the claims process for a situation like this is handled?

  512. April 19th, 2011 at 1:46 pm #Jason

    Dennis,
    You are correct. The insurance company does require an itemized list for the items damaged in the event of a loss. You would need to provide this list regardless if had replacement cost or and actual cash value policy.

    What seems to be a little confusing here is that your personal property coverage is based on (for example) 75% of your home’s coverage. That generally is an adequate amount of coverage for a typical homeowner. The insurance company doesn’t need to know specifically what they are insuring, but when a claim occurs, they need to know what they are paying for. If everyone had to provide a list of all the things they wanted covered by a homeowner policy, that would be time consuming for every new or renewed policy issued. To do a percentage coverage saves time and provided adequate coverage for 95%, or more, of the homes that are insured this way.

    I think you agent may have not fully understood your question when you and he were discussing your “what if” claim.

  513. April 20th, 2011 at 6:47 am #F MICHAEL CONTE

    I agree with jason and i would suggest that you continue to talk to agents.

  514. May 7th, 2011 at 12:24 pm #JOYCE A. BUTLER

    HOPE YOU CAN HELP ME WITH THIS. I HAD A FLOOD IN MY BASEMENT A FEW WEEKS AGO. I HAVE TWO SUMP PUMPS DOWN THERE. ONE MALFUNCTIONED AND STOPPED WORKING; THE OTHER ONE ALSO. I CALLED AND GOT A GUY THAT DOES A LOT OF WORK FOR US TO COME AND PUT IN A NEW ONE. (THIS WAS ON A SUNDAY). I SPOKE WITH MY STATE FARM AGENT ON MONDAY AND HE HAD THE ADJUSTER CALL ME. I PROCEEDED TO TELL HIM WHAT HAPPENED, AND ALSO TOLD HIM THAT I HAD MANY OF MY BELONGINGS DOWN THERE THAT WERE RUINED. HE BEGAN TO TELL ME THAT MY INSURANCE WOULD NOT COVER IT AND THAT THE ONLY THING THEY WOULD DO IS BLOW IT OUT AND DISINFECT IT. PLUS, I HAD A $1000. DEDUCTIBLE, AND THEY MIGHT PAY FOR MY SUMP PUMP. HE SAID THEY WOULD NOT COVER ANYTHING I HAD IN MY BASEMENT BECAUSE IT WAS NOT FINISHED OFF. I LOST COUCHES, LOVE SEAT, REFRIGERATOR, DVD’S,
    AND A LOT MORE. I WENT BACK TO MY AGENT- HE WAS QUITE RUDE TO ME, AND STATED THAT NO INSURANCE AGENCY COVERS A BASEMENT UNLESS IT IS FINISHED, BECAUSE THEY JUST DO NOT KNOW HOW TO WRITE THAT UP. I CALLED A COUPLE OF OTHER INSURANCE COMPANIES- THEY SAID THEY DO COVER THIS. I ALSO RECEIVED A LETTER FROM STATE FARM SAYING THEY HAD GOT MY CLAIM BUT I REFUSED TO SUBMIT IT- IT WENT ON TO STATE THE TIME FRAME THAT I HAD, IF I WANTED TO FILE A CLAIM. I CALLED THEM AND WANTED TO KNOW WHY THEY WOULD SEND A LETTER LIKE THAT. THE REPRESENTATIVE STATED THAT YOU COULD NOT HAVE RECEIVED THAT- I PROCEEDED TO READ THE LETTER THAT I HAD RECEIVED TO HER. SHE SOUNDED VERY UPSET AND TOLD ME I SHOULD NOT HAVE RECEIVED THAT LETTER. MY POINT IS THIS-SOMETHING IS WRONG HERE. I HAVE BEEN HAVING TROUBLE WITH STATE FARM FOR THE LAST FEW YEARS AND WILL BE TAKING ALL OF MY BUSINESS TO ANOTHER INSURANCE AGENCY EFFECTIVE MAY 13, 2011. CAN YOU TELL ME IF THEY WERE RIGHT IN THIS- THAT DAMAGES TO AN UNFINISHED BASEMENT ARE NOT COVERED? IT SHOULD NOT MATTER IF YOUR BASEMENT IS FINISHED OR NOT. I THANK YOU IN ADVANCE FOR ANY HELP THAT YOU CAN GIVE ME.
    JOYCE A. BUTLER

  515. May 7th, 2011 at 1:57 pm #Jason

    Joyce A Butler,
    Posting in all capital letters is not very easy to read. Using sentence style writing is a lot easier to read. This information is provided in the event you post again.

    There are a couple of things at hand here. The first is that a sump pump overflow and sewer backup endorsement generally is required to be attached to a homeowners policy for coverage to apply for damage from the situation you indicated. If you have that coverage, it is in most cases limited to $1000, $5000, or $10,000 in damage. You would have to review you policy to see if this coverage is there. Also, generally, the deductible for this coverage part changes to $500 per occurrence. (Even if your policy has a $1000 deductible). Personal property in a homeowners policy is covered anywhere in the world (restrictions may apply). The issue of finished basement or unfinished basement is not relevant. What is relevant is what caused the damage (failure of sump pumps). Depending on how the sump pumps are damaged, the damage to the pumps may be covered by your main policy and subject to your $1000 deductible. The damage to your personal property is dependent upon whether or not you have the sump pump overflow and sewer back up endorsement.

    Short of knowing if you have that endorsement, it is difficult to speculate if this is covered and it doesn’t matter if you basement is finished or not.

    For example, the damage to your sump pumps would be covered if damaged by lightning. Sump pumps certainly do not cost more than $1000 so that is where your claim may end. Do you know if you have a sump pump overflow or sewer backup endorsement?

    And a good rule of thumb is to check around for different insurance companies and coverage every 3 years whether you switch or not. It sounds like you may have reached the point in time to switch. During the time you are checking for different insurance, it is also a good time to discuss with your new agent if you have the types and kinds of insurance necessary to protect your property the way you want it protected

  516. May 8th, 2011 at 6:28 am #F MICHAEL CONTE

    Dear Joyce,
    Jasons comments are dead on pertaining to the sump pump exclusion/ endorsement. Here is what i suggest.

    Let me start off by saying i am an indepenant agent and have been for my entire life. Most people do not realize the differance that an independant agent should bring to the table. First we represent many companies and must be familiar with the various products offered by those campanies, second most independants are rather savy when it comes to claims, and in my case have no problem going toe to toe with an adjuster or claim rep.

    Many companies deal through captive agents (the company you mentioned is one) a captive agent represents one (yes one) company, so right wrong or otherwise you end up with that company’s product. additionally one might question who that agent really answers too, his customer or the only company he/she represents who could cancel their contract at any time?

    So the next question is does your carrier (assuming you do not have the sump pump endorsement) offer such coverage? if they do, was it offered to you? did someone inspect your home? if they did, did they note the sump pump? If they noted the sump pump, did they review your contract to see that you had the proper endorsement? Also if they inspected and did not note the sump pump, the question becomes what were they inspecting, and why didnt they identify the potential gap in coverage. If they offered the coverage to you and you did not take it, game ends here. If they have the endorsemnt and no one offered it then game on.

    Although this is a small property damage claim you might suggest this path to an attorney, attornies typically do not like to take property damage claims. Keep in mind there is always small calims court. if you go that route follow my rational and i think you will be successful. when you shop for insurance ask the broker if he/she is an independant, also ask what type of claims services and expertise they offer, after all you only need insurance when there is a claim…..Good Luck, and sorry if this sounds like a commercial for independants, but truly we are going the way of the neighborhood drug store…..non existant.

  517. May 8th, 2011 at 10:18 am #Jason

    F Micheal Conte,
    I appreciate your posts. I believe all insurance should be sold by independent agents. Independent agents have a magnitude of companies they can utilize and they can support good companies by writing policies through good companies and avoid companies that are not so good. That only makes sense in this free market system we live in.

    A simple example is a person who is looking for the best car for goes to a Ford only dealership. This Ford dealership can be compared to the captive agent who sells only one make (or the insurance coverage of that single insurance company). There are likely many, many cars more capable of matching a person’s needs and wants that are not Ford makes but the Ford dealer is only able to offer those cars.

    This does not translate to customer service at all by limiting your products to only one company. Keep up the good work as an independent agent. I hope independent agents are here for good because we need agents like you.

  518. May 9th, 2011 at 11:02 am #Emma

    I had water damage to half my kitchen which included a row of kitchen cabinets/countertop. The rest of the cabinets are not damaged but since the home was built in the 60’s there is no way to match the cabinets/or counter tops. Is it reasonable that they reface them or replace them even though they are not damaged, so they will match the rest of my kitchen.

    Also, what is the typical requirement for insurance companies to pay for building requirement/compliance issues when fixing items. For example, to fix the water leak they opened up the wall that has the dryer vent. It is piped to my attic, I am told by my contractor that is now considered none compliant and we will have to re-route vent to outside. Should insurance pay for this since they are paying for that wall to be fix?

  519. May 9th, 2011 at 1:39 pm #JOYCE A. BUTLER

    Jason,
    Thank you for letting me know about the capital letters. Will remember.
    I also thank you for the advice you have given me. Will try to find my policy. We have had our home with State Farm for over 20yrs. and my
    husband cannot find the policy. The sump pumps were put in when we had this home built in 1991. Will try and get the policy from them. Again I thank you very much for your advice.
    I called State Farm today and requested the whole policy and not bits and pieces. They said they would look it up and send to me. Only time will tell if they do.
    Joyce A. Butler

  520. May 11th, 2011 at 6:13 am #Steven Wright

    My house flooded several months ago. I had flood insurance and they agreed to settle for 80k. They cut the check to me and my mortgage company Wells Fargo. They are holding the money and releasing it in 1/3ds and they said whatever is left after the work is 100% complete and inspected will be given to me, the homeowner.

    I am just trying to figure out how much I should spend on the repairs. If I can get it done the same as it was before with a professional contractor for lets say 60k, will the $20k left be a problem for them to release to me? Also do I have to have 50% of the price in receipts or quotes before they will release 50% of the funds?

    I am just wondering if I actually would get any of the money left over from my insurance claim after the work is completed, or would I be better off just to spend the entire $80k. Will they actually give me the $20k if it was left after the repairs are done or should I just find something to spend it on and end up with nothing left over? They said I would get what is left but does this actually happen? This is my first house an flood claim and I have no idea what to do about this. Any thoughts feedback or experiences would be greatly appreciated. Thanks!

  521. May 11th, 2011 at 8:25 pm #Jason

    Emma,
    That is correct. There is no possible way for the insurance company to match you cabinets. They cannot make cabinets that are 50 years old. So nothing will match what is existing. You policy indicates that it provides coverage for direct damage for property that is damaged. The policy repairs or replaces with common building materials that are new. Does the insurance company owe to replace cabinets that were not damaged but will not match the existing ones? No, but some adjusters will allow that. Your concerns could be brought up with your claim adjuster to see if they will allow all to be removed and replaced.

  522. May 11th, 2011 at 8:30 pm #Jason

    Steven Wright,
    Proof of completion can be done by receipts, invoices, etc. Also, a visual inspection could be done to determine the extent of completion. It depends on what you lender wants for verification before they will release the funds.

    Will you receive the left over funds when 100% of the work is completed? Sure, if that is your arrangement with them, you will. The lender wants to make sure they have the same collateral for the loan that they did before the damaged. If there collateral is resumed, they will provide any left over funds to you.

  523. May 12th, 2011 at 10:03 am #Ronnie

    I had a flood in my kitchen from a dishwasher hose that apparently has been leaking for awhile but must have just burst Monday night.. apparently my floor slopes to the left of the DW and all of my cabinets are elevated on a false bottom that has supports that run front to back on the cabinets to elevate them.. the water emerged Tuesday morning under a cabinet 3 and 4 sasections away from the DW .. the cabinet where the water emerged is warped and I know that the company that made my cabinets is out of business becuase I had to replace a builtin refrigerator a couple of years back that was cabinet faced and I could not get replacement panels.. the insurace adjuster keeps asking how old the DW is and I really am not sure maybe 8 or 9 years .. why does this question keep coming up?

  524. May 12th, 2011 at 7:34 pm #Jason

    Ronnie,
    An adjuster will write an estimate to replace the damaged items. A subsection of the estimate will include depreciation which is adjusted from the total estimate. Generally, a wide-accepted way to apply depreciation is upon the item’s age compared against the useful live of an appliance. Another part of the same estimate will show the actual cash value (ACV) of the items damaged which is the replacement cost less the depreciation of each item.

    Your policy likely is a replacement cost policy but there are 2 stages of claim settlement of the policy that the insurance company can choose to use to settle the claim. The first part of the claim will be payment for the damaged items based on their ACV cost. This amounts to a down payment to complete the full repairs or item replacements. When the repairs or replacement have been completed, you are allowed to make a claim for the recoverable depreciation which is the amount subtracted for the depreciation of the items in the estimate.

  525. May 17th, 2011 at 12:57 pm #Mandi

    Hello,

    I have an ice dam claim that started in on Feb 4th 2011…. he came out Feb 17th and inspected the property and agreed it was significant damage, him and my contractor agreed on a bunch of stuff at that time.
    March 9th rolls around and we have not received anything from him so i called and he told me he forgot to do my estimate. we finally got it March 16th along with payment. He missed a whole room along with the ice dam removal, lead testing, and replacing carpet where he removed it and such.

    My contractor wrote him a suppliment including everything they discussed in the intial meeting. he recieved that March 30th. I called him April 4th with him only telling me he hates my contractor and to go with someone else and he refused to come back out and reinspect.

    I called him April 21st and asked him why nothing has happened he said he would agree to talk to my contractor over the phone. my contractor has called him or emailed him every day since then with no reply. I called HIS boss May 12th and was assured he would get him to contact my contracor. Still no contact. What should i do?? this is getting drawn out i would like to start repairs.

  526. May 17th, 2011 at 1:08 pm #F MICHAEL CONTE

    Mandi,
    What insurance company is this?

  527. May 17th, 2011 at 1:47 pm #Mandi

    Travelers Insurance. We are in MN.

  528. May 17th, 2011 at 4:26 pm #Jason

    Mandi,
    Call the adjuster’s supervisor and request that the supervisor handle your claim until it’s concluded.

  529. May 17th, 2011 at 6:21 pm #maceo

    my adjuster to 33% of my insurance check, now i can’t repair my house. is there a cap on how much an adjuster can charge in florida.

  530. May 19th, 2011 at 3:42 pm #Vickie Blankenship

    We had a house fire that was ruled as arson. We were not involved and are horrified about this. Our home was on contract to sale to a buyer. Now we are being told that the insurance company may not cover the claim since it was ruled arson?

  531. May 19th, 2011 at 3:58 pm #Jason

    Vickie,
    There are two types of arson. One is criminal and caused by someone who doesn’t have an interest in the home. The other is fraud when a the owner or owner sets fire to their property and makes an insurance claim. You have to be careful not to believe everything you hear. Who told you this would not be covered by your insurance company? If it’s someone like your neighbor, that is not a good source. If it’s your insurance agent, your attorney, or the insurance company claim representative, then that likely may be true. Although you had a question mark on your last sentence, you didn’t ask a question so none have been answered.

  532. May 19th, 2011 at 4:50 pm #Vickie

    Jason,

    Our insurance adjustor told us that she has never dealt with any cases involving arson but that she doesn’t think it is covered…. The question is just if this is true?

    The home had been sold and we were to close this month.
    Thanks,
    Vickie

  533. May 19th, 2011 at 7:38 pm #Jason

    Vickie,
    It’s either covered or it isn’t. There is no “thinking it isn’t covered”. That doesn’t work that way. If this is criminal arson and you have no involvement in it, this should be a covered loss. This adjuster should not be making comments like that since it appears she is not qualified to be interpreting an insurance policy. If this was my claim, I would ask for another adjuster who is capable of handling your claim. I have my doubts about your current adjuster.

  534. May 19th, 2011 at 7:57 pm #Vickie Blankenship

    Jason,

    We definitely have NO involvement in this. We had sold the house and it was getting ready to change hands, but now it can’t go to settlement as is.

    She said that it could take months to complete the Arson investigation and that was her exact words to my husband this morning.

    She said that she has had no experience with Arson in the past. She said that from what she has read that she doesn’t think it would be covered.

    The only problem is… when we call and ask to speak to somebody else, they always transfer us directly to her voicemail. She NEVER replies to voicemails and we have to constantly call until she picks up the phone.

    The fire marshall’s office has rulled it as arson. Our insurance fire investigator agreed with these outcomes. However, as stated before, we had no financial gain and no motive to do this.

    We are now having to pay an insurnace deductible as well as maintain the house payments, insruance, electric, etc until the house is acceptable for settlement.

    I am ready to pull my hair out. My husband is on military deployment in Missississippi preparing for Afghanistan and we want some sort of closure, so that we can determine if this house will go to settlement or not.

    Thanks,
    Vickie

  535. May 20th, 2011 at 5:25 am #Jason

    Vickie,
    There are a couple of things at play here. First, people who are inexperienced (claims adjuster) are making statements they should not be making at this point. It is critical that qualified people are handling your claim.

    I would say your claim is in limbo while the arson investigation is completed. What it appears they agree upon is that the fire was started intentionally. Their investigation has to continue to either rule you or somebody working at your direction caused the fire, or rule you had no involvement in the fire.

    Because of the circumstances, you are the main subject of the arson investigation until you are cleared of that role. You may be asking if you need to get an attorney. It probably would be a good idea to talk to one. There’s a big stake at risk which is a substantial amount due to your house fire.

    Your insurance company should be paying for your added living expenses at this time including rent, extra utilities, extra food expense, etc. That is what insurance is for – so you don’t have to pay for 2 households. Your claim at this time is neither accepted nor denied. It is in a limbo status while they make a determination of coverage. Your extra expenses should be paid by the insurance company while in the limbo state.

    I hope your closure comes quickly but it could be months to conclude an arson investigation. It’s not so important that they find out who started the fire, what is important to you is that they rule out any involvement by you. And ruling you out could occur quickly but I don’t know all the circumstances.

    Please post the name of this insurance company so we all can take note that this company utilizes untrained and inexperienced adjusters on complex claims.

  536. May 20th, 2011 at 6:38 am #Vickie

    Jason,

    Thank you for your assistance. Believe me, we have already retained an attorney! This entire situation is ridiculous! The house was SOLD!

    Our insurance company is USAA!

    And further advice would be greatly appreciated. I’m pretty much on my own battling the insurance, with my husband’s deployment.

    Thanks,
    Vickie

  537. May 20th, 2011 at 7:27 am #Jen

    Hi,
    I have had a house fire of one of my rental properties. The insurance check was for over a hundred thousand dollars. My bank wants me to deposit and get payments on as repairs are done.
    My question is after repairs are done and they send an appraiser out what happens if it does not appraiser for as much as it did when I bought it( we all know the market now is not good). ( house appraised at 147000 then, mortgage at 112000 now) Can they keep any of the money that was from the insurance check?
    Can I get my own appraisal? They said they use theirs.
    Thanks for any help
    Jen

  538. May 20th, 2011 at 8:03 pm #Jason

    Jen,
    The matter of the bank providing your funds as the repairs are completed is a matter of them making sure they get the same collateral as they had before which happened to be an undamaged property. They should not be sending an appraiser to inspect or value the property. All they want to know is that the repairs are completed so they can release the funds to you. That is your money but the damaged house is their collateral for your loan. There is no need to be concerned about the market value of this property. If anything, after the repairs are completed with new materials, the property will be worth more than in the pre-fire condition. Oh, and another thing – the bank has no desire keep any of your money. They will gladly release it back to you as the repairs are completed. It’s not an adversarial situation at all.

  539. May 20th, 2011 at 8:15 pm #Jason

    Vickie,
    I agree with you that the situation is ridiculous. The insurance company should be updating you with information about what is going on so you have all the answers. I don’t care if the information is good, bad, or indifferent – you still need to be told the entire process. You are their insured and their customer. Sure it’s going to be stressful either way but knowing the information about what is going on can alleviate a lot of stress.

    I’m not an attorney and your attorney knows you situation a lot better than I do. I can tell you that they will probably want to take a recorded statement from you or a maybe even a deposition which is a video recorded statement usually with an attorney asking you questions. Your attorney can better advise you on these things.

    It is a good sign for you that the house was sold and the closing was coming up. That is a lot better than if the house was on the market for over a year and no offers had been submitted. In all likelihood, I really don’t see the buyers sticking around to buy your house after the fire. You may have to get the house resold after your claim is settled and the repairs are completed.

  540. May 23rd, 2011 at 1:13 pm #JoAnn

    We have a finished basement-now a total mess-water– ground water they say- I would like to know how Ins. places can say something is covered on one page and 6 pages later they state it is not. And in the end they go with of course page 6 and you are left paying them for the policy and for the total clean up of the damage? How is this right and legeal??? We have Nationwide–belive me they are not on your side….

  541. May 23rd, 2011 at 5:01 pm #Jason

    JoAnn, ground water is something that insurance companies don’t want, and don’t intend to cover. They base their coverage on where the water source came from. If it’s a broken pipe, leaking appliance, overflowing bathtub, etc, they provide coverage for those causes. Ground water is one that they don’t provide coverage for. That and flooding. That what flood insurance is for and I believe the flood insurance is available through many insurance companies but is supported by the government.

  542. May 26th, 2011 at 3:33 pm #Vanessa

    I live in Texas and a winter storm killed 5 very large palm trees on my landscaping. I called my State Farm Insurance and the lady informed me that homeowners insurance does not cover trees or shrubs in Texas? Are you aware of this? Can you direct me to where I might find clarification as well?

    Thank you for any help,

    Vanessa

  543. May 27th, 2011 at 9:44 am #Jason

    Vanessa,
    trees are likely covered in your homeowners policy but for limited causes of loss like from lightning, fire, vehicle damage, and a few other causes of loss. I am not aware that freezing is a covered cause of loss. Your tree loss appears to not be covered.

  544. May 31st, 2011 at 1:08 pm #William

    My house got flooded on boxing day, i submitted my contents claim, now the insurance company want to take 25% off my claim, for ware and tare etc, and the fact they can get big discounts from suppliers is this correct.

  545. May 31st, 2011 at 1:23 pm #roofclaim

    My insurance company is paying to reshingle my roof due to wind/hail damage that happend oct 2010, they finally inspected it may 14th. They did not get out in time in 2010 before snow fall to check the damage. Now the decking is compromised from water seeping in all winter. Will they write a suppliment once they get pictures of the damage to the decking and bring it up to code since it is damaged?

    we have 1/2 inch sheathing i believe code in MN is 5/8ths or more.

  546. May 31st, 2011 at 1:41 pm #F MICHAEL CONTE

    William,
    What caused the flood? broken pipe tidal water overflowing bounds? advise
    does you policy provide for replacement csot on contents?
    Who is your insurer? Where are you tha they celebrate Boxing Day?

  547. May 31st, 2011 at 4:02 pm #Jason

    William,
    This depreciation (25%) in your case is common when settling claims and has already been discussed in this forum several times. Your policy pays for the ACV (actual cash value) of the items. When you replace the items, you can submit an additional claim for the recoverable depreciation (25%). That is just how the policies are written.

  548. May 31st, 2011 at 4:05 pm #Jason

    Roofclaim,
    In regard to your question, that is correct. Your questions and concerns should be directed to your adjuster because that person will do the supplement estimate.

  549. June 2nd, 2011 at 11:12 am #Maria

    I severly cut my thumb last week in the kitchen of my home. The bills are adding up very quickly and are currently already over $1100 and I havent even gotten the stitches removed yet. I have already spent $200 out of pocket and my parents keep telling me I need to file a claim with my home owner’s insurance……..is this a wise idea?

  550. June 2nd, 2011 at 11:39 am #F MICHAEL CONTE

    Maria,
    There is no reason to file a claim with your homeowners carrier. Home insurance covers your home and a component called liability covers you for harm you do to others, and medical expense for non residence. for example if i were at your home and i cut my finger while helping in the kitchen, i would be able to seek coverage from the medical expense portion of your poliy. if you cut me whil you were cutting fruit or some typoe of food i could also seek remedy from the liability portion, but i am afraid that there is no coverage for your situation.

  551. June 7th, 2011 at 3:43 pm #Tim

    I am working through a claim for water damage due to a leaking pipe. I called a restoration company, (it was early on a Sunday morning) to clean up the mess. Then I called the insurance company to start the claim process. The restoration company bill was $12,000. The insurance company sent me a check for $7,000 stating that is what is “reasonable”. Do I have cause to go after more from the insurance company?

  552. June 8th, 2011 at 5:10 pm #Jason

    Tim,
    If you owe the restoration company more money because of what they did, then the insurance company should be paying more for what the company did to protect and restore your property.

    If you are asking if you have a legal position to sue the insurance company, we refrain from provided input about that and refer you to discuss with an attorney.

  553. June 9th, 2011 at 5:19 am #Tim

    I do not plan on taking any legal action. The restoration company billed for 28 hrs labor. (which I think is fair) The insurance company quote was for 8 hours. (which I think is crazy) The insurance company is also having an issue with “drying time for equipment rental” and other charges that the insurance company deems excessive. I didn’t think I should be required to pay the difference. I was curious if this was typical or legal for an insurance company to pay only a portion of a clean up bill, etc.

  554. June 9th, 2011 at 7:04 am #Jason

    Tim,
    You were there and you are aware what this restoration company did. 28 hours is basically 3 full days of work.

    If the amount is billed, the insurance company should be dealing directly with the restoration company to get the bill adjusted or simply pay it. They don’t have any other options than these.

    If you have the check of $7000, it may be wise not to cash it or use it to pay the restoration company until everybody can agree with the total amount that is going to be paid for the restoration work. The insurance company, the restoration company, and you all have to agree with the charges and what is paid for those charges.

  555. June 9th, 2011 at 7:39 am #Tim

    If the restoration company and the insurance company cannot agree, should I be stuck with the balance? They are now refusing to speak to one another. The delta a few days ago was $5400. We are now down to $1000 difference. The restoration company issued its final number. Do think I should eat the $1000 and move on, or push the insurance company to cover the difference?

  556. June 9th, 2011 at 8:11 am #Jason

    Tim,
    Do you want to eat the $1000 bucks? Let these two companies figure it out. They compromise and work things out every day. You should not be in the middle. You pay your premium to get coverage for things like this. Do you pay your premium so you can pay an extra $1000 because the billing company and the paying company can’t agree?

  557. June 9th, 2011 at 9:01 am #Tim

    These two gentlemen really dislike each other. Negotiations are at a standstill. (name calling) Unfortunately, I hired the restoration company. The insurance guy is telling me he is up to his “max” allowed compensation for the cleaning. Can this be true? Do I have any recourse with the insurance agent? (I don’t want to get involved in the legal system at all. I am looking for a negotiation point.)

  558. June 9th, 2011 at 9:12 am #Jason

    Tim,
    You are the only one that can hire the restoration company. It’s your home and you are the only one that can hire someone to perform work there. The insurance guy is not maxed out on anything. There is no set amount for the insurance you have except those numbers found on your declaration page in which you likely have your home insured for at least $150,000. When the insurance person exceeds this $150,000 (for example) he still won’t be maxed out because usually policies have language that increases the stated limit by 5% (or more) for misc. things such as fees, code upgrades, ect.

    Do you have any recourse with you agent? Sure, you can find another agent and insurance company with which to insure your home.

  559. June 9th, 2011 at 9:37 am #Tim

    I am looking into a new company. However, homeowners insurance is difficult to come by in south Texas. Is there someone higher up the food chain that can approve the additional funds to keep me whole?

  560. June 9th, 2011 at 10:27 am #Jason

    Tim,
    Yes, there is someone higher up. Talk to a claims manager of this person that cannot seem to approve a restoration bill well below you policy limits. If that doesn’t work, speak to the claims manager’s manager. Usually, a call to the first manager will resolve things. However, this really isn’t your battle and it is between the insurance company and the restoration company to get the bill resolved.

  561. June 9th, 2011 at 11:57 am #Tim

    Unfortunately, that ship has sailed. I sat down and reviewed the Restoration Company bill line by line and agreed on a fair number. In good faith, I have paid the restoration company. It was the right thing to do. My negotiation now is with the insurance company.

  562. June 9th, 2011 at 1:30 pm #admin

    To all of our great contributors:
    You may show your company name and website address at the end of each post if you think our visitors might benefit from your services.

  563. June 9th, 2011 at 10:16 pm #Jason

    Tim,
    Good luck with the insurance company. I believe they owe for the total amount of the bills, except for your deductible. For you, this is the right thing to do. For the insurance company, this is business which includes profits.

  564. June 9th, 2011 at 10:20 pm #Jason

    Admin,
    Thank you for your consideration. I have no employer or company I represent. Also, I have no web site address to post.

  565. June 9th, 2011 at 11:04 pm #admin

    Jason, thank you for your selfless contribution.If all adjusters were like you, this website would not be needed!

  566. June 12th, 2011 at 5:54 pm #Justin

    Hello,

    The tile feels warm in front of our bathroom sink and in the small laundry room on the first floor of our house. Does this mean we have a water leak. How do we report it to insurance?

  567. June 12th, 2011 at 7:06 pm #Jason

    Justin,
    Generally the presence of water is around when there is a leak. I have no idea why your tile feels warm. You may want to do a little more review of your situation to determine if you simply have warm tiles or if there is a water leak. If there is a water leak, it may be wise to determine that and correct that condition as soon as possible. At this point and until you find out more, I don’t think the agent or insurance company would want to have a claim concerning a warm tile floor.

  568. June 14th, 2011 at 1:15 pm #Tim

    Negotiation with Agent has ended. He refused to pay any more money to the restoration company. He feels he has already paid more than is reasonable. I ended up paying $1,000 over the deductable.

  569. June 15th, 2011 at 5:54 am #samr

    I had a “total loss” house fire in Feb. SF paid me $350k, the “policy limit” on my structure, but estimated it would cost in excess of $560k to rebuild. (it was a renovated church built in 1852)

    I would be possibly be able to acquire an additional $35k in Law & Ordinance and another $70k in “option ID”… if needed. (350 + 105 = 455)

    After speaking with architects and engineers, they believe it would cost at least the $560k, or more. I have decided not to rebuild, I can’t afford it, and buy another home with the $350k.

    My question is.. I did not set the policy limit of $350k. SF said it is up to the insurer to tell them what limit to set the policy, not their responsibility. Is there anyway to prove that my home was undervalued and try to get SF to give me more money… or would it be too difficult to pursue?

    Thanks!

  570. June 15th, 2011 at 6:30 am #F MICHAEL CONTE

    Dear Samr,
    This is an excellent question and one that i do not know the exact answer to and hopefully someone on this board does, but here is what i can offer.
    I am abroker in new york state, if i prescibe a limit of insurance to someone, which turns out to be wrong i can be held accountable. When you deal with a captive agent are they free of this responsibility? I do not think so. Many times the carrier that i represent will do an inspection which comes in lower that that which the insured beleives to be correct. I have always said to these customers that they now poses the best insurance protection ever. i say this becuse if the cust wants to insure at 100K and the company insists on a lower amount which turns out to be inadequate, i belive the carrier would have a hard time in court, justifying thier position. So here is my question to you , did you initially insure the building for a higher amount? did you insure it for a lower amount and they conducted an inspection and then advised that you needed to meet their level?
    Bottom line, i think you need to be able to show that either you tried to insure it for the proper amount and they refused to take your direction, or they insisted based on thier report, which if relied upon by you and turned out to be wrong would make them accountable. they pd you the policy amount so quickly to get rid of you, there are people on this board that have small claims that have been trying to get paid for years. I hope someone can offer better insight to this point, much of this is based on how i belevei it should work perhaps someone can show where this was tested in court.

  571. June 15th, 2011 at 6:31 am #Jason

    Samr,
    Obviously your home is under-valued because it will take at least $560,000 to rebuilt it to the prior condition. The market value of the home was likely less than $350,000 so it was insured for a range in-between the market and the replacement value. With $455,000 available to you to rebuild, you would have funds to bring it very close to a home without having to first make it a church.

    As far as the valuation of the home, you are the owner, you have the vested interest in the home. It makes more sense that YOU would want to make sure it insured to a proper replacement cost rather than the insurance company. Think about it. Your home was under-valued. You received a check for your policy limits in which you paid your premium to receive that limit. You can’t go back in time and pay a higher premium to get higher limits because there are no do-overs when it comes to this. Whether you are successful in “proving” it was under-valued or not, it is going to be extremely difficult to pursue. What will be the end result? All I know is that you would have to pay an attorney for their efforts and they will get paid whether you recover nothing more from the insurance company or if you recover $500 more or $20,000 more. If you have to ask if it would be too difficult to pursue, then your attorney fees will likely consume any additional you would receive, if you received any at all. So, the worst case scenario is you receive nothing and pay your attorney their entire bill. This is a question only you can decide.

  572. June 15th, 2011 at 6:41 am #F MICHAEL CONTE

    Jason,
    i agree 100% with your comments, i have however been in the situation where the carrier dictates the rebuilding cost despite our objections.

  573. June 15th, 2011 at 7:08 am #Jason

    F Michael,
    I agree with your comments too. The thing is I don’t want to do is send this person on a mission where the odds of success may or may not exist but are very, very costly regardless of the outcome. Only an attorney could provide advice about this situation; however, since the attorney gets paid regardless of the outcome, who knows if the attorney is providing accurate information?

  574. June 15th, 2011 at 8:12 am #samr

    Thank you for your comments. Never being in this position before, it is very hard to get an honest intelligent response to my questions from people who might actually know something.

    The original HO policy was taken out 14 years ago. The agent came to the property and worked up an amount. He is no longer with SF and I don’t have any documents related to the estimate. It’s hard even to remember that long ago:) The policy limit does go up a minimal amount each year for cost of living increases to cover building materials/labor etc.

    I have a friend that tried to lower their HO policy limit to save money and their ins. co. would not let them. Shouldn’t the ins. co. want to have an accurate estimate in what they insure anyway?

    .. and I do believe I was paid quickly to get me out of the way…

  575. June 15th, 2011 at 8:37 am #F MICHAEL CONTE

    Samr,

    I am an independant broker/agent, we try to look at each renewal for rebuilding values, we try to engage the costomer in discussion surrounding improvments they are making or have made. Most people look at insurance as an evil cost and do not want to have an honest discussion. people look to cut cost on their biggest asset becuse they do not see an immediate return on this asset. i think you have seen the value of having this talk with an independant agent, most people do not see or understand the added value, and many independents fall short as well.
    Sincerely.

  576. June 15th, 2011 at 8:45 am #Jason

    Samr,
    You don’t have to believe you were paid quickly to get you out of the way. You were definitely paid quickly to get you out of the way. F Michael indicated that, you indicated that, and so have I. Insurance is a business and they won’t make any more money off that property. It is all expenses for them after a loss so they figured the best and fasted thing to do was pay you policy limits, let you know about what is available for code upgrades and such, and move on to work with and settle the next claim. Good luck with your endeavors.

  577. June 26th, 2011 at 12:03 pm #Tim Moss

    I had a tree fall on my house over a month ago. The claims adjuster has been out to my home three times. I have a custom built home and the builder is going to do the repairs. The third time the adjuster came out he had another contractor, he said, ” He’s only here for the scope of work”. It appears to me the adjuster doesn’t know what he’s doing. My builder and the adjuster are going back and fourth on the price for repairs and I’m stuck in the middle. I just want my home fixed. Please help me on what I can do to remedy this situation. I have over $375,000 in dwelling coverage, whats the problem?

  578. June 26th, 2011 at 4:59 pm #Jason

    Tim,
    That is what it sounds like. The adjuster doesn’t have the ability to write an estimate for your damage. Take a proactive approach, find the contractor you want to do the repairs, and then coordinate that with your adjuster. This should not be taking that long.

  579. June 27th, 2011 at 8:23 am #James

    If my 16 y/o son accidentally lit his bed on fire, but still saved the house ,would insurance cover that? and could he be charged with arson if i was an accident?

    please get back soon insurance agent coming today.

  580. June 27th, 2011 at 6:33 pm #Jason

    James,
    Insurance covers for fire damage and fires happen all the time. Now the important point here is did your son intentionally light a fire on the mattress and it got out of control? Just because you indicated he lit his bed on fire accidentally, doesn’t mean that is what happened. Did your son light the bed on fire to burn the house? There are many questions to be asked about this. They range from what did your son light his bed with? When did he do this? Has this happened before? It’s likely your financial situation will be investigated too.

    The thing is that it’s rather difficult to light a bed on fire without actually wanting to do light the bed on fire.

    I don’t need to know the answers to any of the questions but those will some of the questions (and very many more) that will be asked of your son and you. An attorney can best assist you if this is more than an accidental fire.

    Arson requires intent to burn something for financial gain. I doubt your son had that intention. I don’t know all the circumstances but your son and his actions will be looked at rather intensely.

  581. June 29th, 2011 at 8:24 am #Maggie Mae

    Have had excessive rain and wind and an F1 tornado hit where I live in Arkansas…. on April 14, 2011 .we have pressed board siding/painted/ on our home…we noted that wallpaper was starting to peel off the wall in downstairs bath/adjacent to the outside wall of house…there is guttering but the excessive rain for 2 months would have been hard for any gutter to handle at times….the wall paper started to peel and we peeled back and have discovered moisture from the outside..adjustor is coming out to look with a contractor, we have HO3 Cincinnati homeowner’s insurance..do you feel there is any problem with coverage on this?
    The guttering is 3 years old, as is the roof… (slopes, roof does down to theguttering next to the house…thanks, Maggie

  582. June 29th, 2011 at 9:26 am #Sarah

    In late december, there were confirmed tornados in the St. Louis area as well as dangerous thunderstorms. On this particular evening, my tree was struck by lightening. As a result, this tree has significant damage and is dying. can I make a home owners claim? If so, what particular “wording” must I use in order for a claim to be successful?

  583. June 29th, 2011 at 9:38 am #Amy Tanlim

    I had a water damaged on a section of my house when my water pipe burst. The homeowners insurance company finally sent me a check for the structural repairs. A few days after that I also received a notice of non-renewal to this policy. I still have an outstanding content claims with them. This is my FIRST claim with them and have been paying my premium on-time for many many years (maybe 20 years). Is this normal? With this non-renewal notice, will it affects the premium of my next homeowners insurance? Also can I terminate my current homeowners policy before it expiration date and buy a new homeowners policy from a different insurance company. Will this affect the payment of the outstanding claims with the old insurance company?

    Any advise will be greatly appreciated.

  584. June 29th, 2011 at 10:16 am #Mary

    We’re in Massachusetts and the exterior of our house has been damaged, the damage has been attributed to ice damage. (Roof shingles lifted and water ran down behind the clap boards and caused big (size of a fist or forearm) water bubbles under the paint – sometimes the paint bubbles burst, sometimes they just hold water indefinitely.) Cosmetically, it’s a mess with peeling paint everywhere. Physically, the trapped water is rotting the wood.
    The insurance company is finally, presumably, cutting a check this week and just today my husband told the insurance co. that he is a self-employed contractor and is hoping to do some of the work himself.
    Will this effect the amount of the settlement?
    Do we have to show receipts if we are not pursuing the holdback?
    I read conflicting info about doing the work yourself. Is a homeowner, who is a contractor, entitled to the same rate for doing the repair – or is this viewed as benefitting from a loss?
    And if you can only answer one question – please answer this one:
    If my husband does not do any of the work, does the amount of an insurance settlement get reported as ‘taxable income’ come tax time?
    Thank you!

  585. June 30th, 2011 at 7:01 pm #Jason

    Sarah,
    Simply make a claim for lightning damage to your tree.

  586. June 30th, 2011 at 7:05 pm #Jason

    Mary,
    The cost to have repairs completed to your home are defined in the estimate. That is what your claim is based upon. If your husband does some of the work, that should be fine. Talk to your adjuster to make sure that is ok and then proceed. Insurance funds paid to you are for something you already own and is not considered income. It is to repair or replace what you already had and is not taxed. And typically you can show receipts to show the work has been completed to recover the hold back but you agent or another insurance associate maybe able to document the repairs are completed by personally inspecting, accepting photographs, or some other verification so you can collect that recoverable deprecation.

  587. June 30th, 2011 at 7:10 pm #Jason

    Amy,
    I had a water damaged on a section of my house when my water pipe burst. The homeowners insurance company finally sent me a check for the structural repairs. A few days after that I also received a notice of non-renewal to this policy. I still have an outstanding content claims with them. This is my FIRST claim with them and have been paying my premium on-time for many many years (maybe 20 years). Is this normal? With this non-renewal notice, will it affects the premium of my next homeowners insurance? Also can I terminate my current homeowners policy before it expiration date and buy a new homeowners policy from a different insurance company. Will this affect the payment of the outstanding claims with the old insurance company?

    A general rule of thumb is to shop for a new insurance company every 3 or so years. You are long overdue and chances are you will find the exact same coverage for a lower premium. Will this non-renewal effect you insurability or the cost of insurance? No, not at all. Insurance companies can non-renew for any reason they want. So, yeah, it is normal. Don’t lose any sleep over it.

    Yes, you can cancel you insurance anytime you want and switch. It doesn’t have to be on the renewal date or the cancellation date at all.

  588. June 30th, 2011 at 7:13 pm #Jason

    Maggie,
    Your claim appears one that would be covered in a typical homeowners policy.

  589. June 30th, 2011 at 8:50 pm #Ami

    Hello, we recently had our septic pump struck by lightening in which it was charred and when the septic specialist attempted to plug it back in it began to smoke. Becasue of this lightening strike our basement was filled with level 3 water when our water softner emptied during the night. My agent informed me that if it was lightening or electrical it would be covered in full. The adjuster, who called the restoration company who was at our home hours before he came to our home ( and never called me) stated that it is not covered under lightening and that there is a $5000 cap due to it being a septic back up. I am really struggling with how this can be a septic back up when the septic was clear and working properly and had it not been struck by lightening it would still be working and I would have carpet and drywall in my basement. Thanks

  590. July 1st, 2011 at 3:59 am #Cinde

    I hope I post this in the right area to help someone. First of all, i’m not saying to not tell the truth on a claim…Wear and tear and old things you let go are not covered. Had a customer this week, who I believe was done wrong in my 30 yrs in Insurance. He had been with 1 company over 8 yrs with not one claim. He had a refridgerator that was installed in a wall unit…The unit was only 2 yrs old, so not old. He found out the back had been leaking and he was honest and said he did not know how long…that was it for the adjuster to be able to turn this claim down. Sudden discharge is the only way something like this would be covered under most homeowner insurance so by saying he did not know how long, maybe a year as a guess, his insurance was denied. Again, i’m not saying to lie, but the adjuster listens to what you say, never say you know something has been going on “awhile” unless you know it has. Alot of times they will argue with you and say they think it had gone on awhile but they don’t know that 100%…sometimes the less you say the better. I truly feel sorry for this customer, there was no way he knew this was leaking in a unit as he had and the adjuster should have paid this claim for a long time customer. Thats how I feel after 30 years in Insurance. I did not write this policy, I just service it now but luckily the customer likes me well enough to stay with the agency and not blame us and just let us shop his insurance with another carrier. Thats how insurance loses good customers. He may not have ever turned in a claim again.

    Good luck to everyone.

  591. July 1st, 2011 at 6:13 am #Jason

    Ami,
    You posed no questions so none will be addressed.

  592. July 1st, 2011 at 7:30 am #Ami

    Ok, is there a way to challange the company and make then accountable to cover the loss of my basement that was caused by lightening? How are they able to place the covereage under septic when it was caused by the lightening the struck the pump in which it was not able to do his job? What resources are out there to help? Is it common practice that the adjuster communicate with the restoration crew before myself or even come to our home to assess what happened? Thanks

  593. July 1st, 2011 at 8:42 am #Mary

    Our home was a total loss in a house fire nearly three years ago. Our insurance company paid out additional living expenses for nearly 7 months then denied the claim in full claiming misrepresentation of contents. Their claim was due to a bankruptcy case my husband and I filed prior to the fire. We have been in court several times regarding the validity of their claim. Recently the Judge over their case ruled for judicial estoppel stating we could only claim the contents we listed on our bankruptcy. Unfortunately, our bankruptcy attny advised us to ONLY list major items and list them at “yard sale” value. Obviously, this is significantly lower than our actual contents. I guess our next option is an appeal in the 6th district court of appeals. We live in TN…how to we go about finding a good attorney to appeal this judge’s decision. Any advice would be greatly appreciated.

  594. July 1st, 2011 at 2:43 pm #Jason

    Ami,
    Sewer backup and water overflow are excluded by your policy. Concurrent causation is the non-covered event occurring at the same time a covered loss occurs and it doesn’t matter if the covered loss cause was 99% and the non-covered cause loss was 1%. Now, because you have the septic coverage, you purchased back some of the excluded cause of damage. The stipulation is that you get the coverage for that cause of loss but you have also have a limit. Those limits generally are $5000 but there can be other amounts of this coverage purchased.

    Yes, the adjuster can communicate with the restoration company before they arrive at your house.

    I don’t know of any resources out there for your reference. If you don’t understand your claim, the best contact is your adjuster and if that doesn’t provide the answers to your questions, then a manager at your insurance company would likely be the next person.

  595. July 1st, 2011 at 2:52 pm #Jason

    Mary,
    An insurance company is going to have enough information to deny a claim before it actually does so. If your items are misrepresented, regardless how they got that way, the insurance company can deny your entire claim. From what you indicated, the judge ruled against the insurance company because of estoppel. The way I understand it is that you are then allowed to claim the items that you had listed in the bankruptcy. That may be the best alternative to this entire situation you are in.

    Appeals are expensive. They take a lot of man hours and those man hours are expensive ($100-$250 and hour). You may want to look at the end result of an appeal which is likely not going to be ruled in your favor and then all the appeal attorney fees that you will have to pay regardless of the appeal outcome.

  596. July 5th, 2011 at 11:17 am #Victoria

    We received about $80,000 to repair our home after a tree fell on it and construction is about to begin. If there is left over money because we find deals or something like that, can we keep the left over money? If so, how do we get that from the mortgage company who is keeping the money for us to draw from? Will we get in trouble with the insurance company and/or can they make us repay them?

  597. July 5th, 2011 at 7:15 pm #Jason

    Victoria,
    The mortgage company will release the funds as the word is completed and will release the total of the funds when the repairs are completed. The mortgage company just wants to make sure their collateral is the same or in better shape than when the damage happened. If you are able to do the repairs for less, then that is great. The insurance company has determined the damage to be $80,000 and if you get it done for less, then that is you managing the work and the funds properly. They will not require you to pay it back.

  598. July 6th, 2011 at 2:41 pm #Amy

    Thanks Jason for your answers.

    Please tell me whether if I terminate my old homeowners policy now, will my outstanding claims be affected? That is will they still pay me for my damaged contents which I think is under $10K. It has been more than 6 months and no technicians from the insurance company has come to check out my damaged appliances etc. I like to throw them out but was told not to.

  599. July 6th, 2011 at 8:43 pm #Jason

    Amy,
    Your welcome. Your claims will survive if you switch to a new company. If it’s been more than 6 months, that is way too long for your claim to be on-going. You may need to contact your adjuster, that adjuster’s manager, or your agent. Maybe you need to contact them all to get your claim settled. Even 1 month is too long to have a claim open.

  600. July 7th, 2011 at 4:02 pm #Linda J. Hys

    my contractor who is anderson mitchell would like to know when he’s going to get a check and for how much, since he has 10,000.00 into the garage already. My account # is 0014002557, address is 3911 Lyndale Ave N. Mpls, Mn, 55412 last 4 numbers of S.S. 4802

  601. July 7th, 2011 at 7:03 pm #amanda

    I was wondering, we have hardwoods all through our home that we installed when we moved in 2 1/2 years ago. The carpet is still in the bedrooms from the previous owners. As soon as i step foot in the bedrooms my nose and throat itches me like crazy. I do have allergies anyway but they get worse! I am allergic to cats. I am not sure if the previous home owner had a cat. I was wondering if our home owners insurance would cover to have hard floors put in due to this problem?

  602. July 7th, 2011 at 8:06 pm #Jason

    Linda,
    That is a fairly specific question and I don’t know if any of us can answer that. That might be a subject you want to discuss with your adjuster.

  603. July 7th, 2011 at 8:10 pm #Jason

    Amanda,
    Insurance is to repair or replace damaged property because of something that caused it to be damaged during the time you have it insured with them. The cat odor issues that are coming from your carpet was there before you insured this property. The other thing is that damage caused by household animals is excluded by the any homeowners policy. Another thing is that nothing is damaged because that is the natural occurrence from having cats in the home.

  604. July 8th, 2011 at 8:36 pm #amanda

    well shux! not really the answer i was hoping to hear! That stinks. im not even sure if the previous owners had cats. i was thinking it may have been mattress allergens..and we purchased a new one, but i still have same problems. Its crazy how you can accidently spill paint on ur carpet and have it replaced but they wont after it holds a bunch of microscopic grundge! lol i looked up to see if health ins would cover that, but thats a “no go”. guess i better start saving to get rid of my problem! 🙂 but thank you kindly for taking the time to respond. 🙂

  605. July 14th, 2011 at 6:28 am #Randy

    I have a broken waterpipe under my tiled floor (concrete slab) in Fl. Insurance paid to excavate (including tile replacement) to get to pipe. Tille is not damaged, but runs through out the home. I do not want to destroy the tile because I can re-route waterpipe and solve the leak without affecting the tile. The insurance adjusters report only indicates actual damage to exterior masonry, and no damage inside. Mortgage company released initial portion of money and said repairs must follow adjusters report, and be satisfied through inspection for final payment. Do I have to intentionally damage the home unnecessarily to fix the pipe just because that is in the report , or can I satisfy the issue by re-piping the affected pipe through re-routing? The masonry damage is minor and is already repaired– there is no other damage remaining.

  606. July 14th, 2011 at 10:16 am #Jason

    Randy,
    You apparently got the initial payment for the damage. In order to get the remaining funds which is called recoverable depreciation, you would have to do the work as outlined and prove that the work was done. If you are satisfied with the results right now or have some other method of repair, you can do that but you risk only getting the amount for the alternate method’s cost. If there is no other damage remaining, your claim may already be concluded if you are ok with not doing any additional demolition and repairs.

  607. July 16th, 2011 at 10:34 pm #stuart

    We had a major fire last year and fortunately had very good insurance coverage (Chubb). Our mortgage was significantly paid down to about 20% of the total value. We were issued a check for the mortgage amount in ours and the lenders name, as is standard, that we signed over for the lender to hold. We had a second check issued to us for the remaining value (about 80% o the home value).

    The question is how much is the bank allowed to hold back and when do they need to issue us a check?

    The house was about 80% rebuilt and we asked for them to issue us 80% of the money they were holding (which was only 20% of the value of the house – i.e. loan-to-value of our mortgage was 20%) to pay the contractors for the remaining 20% of work to be done. However, the bank would not issue us 80% of the money they were holding. Instead, for reasons unclear, they thought it appropriate to hold back 20% of the total cost of the construction, which was equal to nearly 100% of the money they were holding. We explained to them that they were holding back 100% of the mortgage, and that we needed the remaining funds to finish the project. They said they understood and agreed that our loan to value of 20% was not as common and was lower than the 80% that is the norm. They said it was the computer program that was not flexible.

    We have been asking for weekly inspections from the bank to eek out funds from them, but this is very frustrating, and we are convinced the firm they are hiring to do the inspection is purposely reporting lower % completion so they can continue to come out and charge for weekly visits.

    What can we do? What are the rules here?

    Thanks.

  608. July 19th, 2011 at 6:22 am #mike

    I live in tenn long story short,i helped my foreman after work put up some siding, a 20 ladder i was standing on kicked out & i fell 15 foot breaking/crushing my wrist.went to urgent care & then operated 2 days later putting a steel plate & 6 screws. prob off 2 months from work. He turned it in too his homeowners.how much should they pay. They have a adjuster that suppose to call me from frontier adjusters in 24 hours it happened 10 days ago.what should i expect. thanks mike

  609. July 19th, 2011 at 10:11 am #Jason

    Stuart,
    Sounds like a bank issue to me. How do you think this is related to insurance?

  610. July 19th, 2011 at 10:16 am #Jason

    Mike,
    Injuries are all not the same. This adjuster may need to determine if the howeowner is liable for your injuries. If there is no liability by the homeowner, there may be medical payments available to assist with your medicals if the homeowner has medical payments insurance. If there is liability by the homeowner, then they may want to obtain a medical authorization from you so they can obtain your medical records to evaluate and arrive at an appropriate offer to obtain a signed release from you.

  611. July 22nd, 2011 at 3:56 pm #brian

    Hi-

    I noticed some water in my basement after a very substantial rainfall (5 inches in under 3 hours). I tried to snake the outside drain and it didn’t work–so i had to dig it up. I’m in the process of tearing down my garage, replacing the driveway (on the other side of the house where the water entered the basement) and planned on replacing the drain pipes under the driveway while the driveway was removed. They dug up the drain tile on the other side where the water entered and discovered an absolute trainwreck of a situation. Apparently NONE of the drains were properly installed. They don’t tie into the street or anything for that matter. Everything flows to the back of the house for some reason. They were even installed upside down. Obviously, whatever they did, it wasn’t done even close to code. We can’t even figure out where the drains go without digging up my entire yard. Whoever did this clearly didn’t pull a permit. Now i need to replace ALL of my drain tiles and run new pipes out to the street and tie them in to the sanitary and storms sewers, not to mention the city is going to require me to waterproof the entire house. $15,000.

    Is this something that would be covered by homeowners insurance? I have Erie insurance. PLEASE SAY YES!!

  612. July 22nd, 2011 at 6:20 pm #Jason

    Brian,
    Unfortunately, water that enters your home at or below ground level is generally excluded. There are a few exceptions but nothing you reported would go in that direction.

    Insurance is a reactionary tool. When there is accidental damage, the policy springs into action to repair the damage. There doesn’t seem to be any sudden and accidental occurence that happened to trigger insurance to step in for you.

    In your case, there is no damage. Sure it’s going to cost you $15,000 but what your are doing are preventative measures to keep water out of your basement from this point onward. And that brings us full-circle to the fact that water that enters your home at or below ground level is nearly always excluded.

  613. July 23rd, 2011 at 8:13 pm #Darla

    I had purchased a home with my now ex-boyfriend. He currently has the house which is still in both of our names. About 2 years ago, the home was vandalized which the insurance company covered.
    My problem is that I am currently wanting to purchase a home myself, but when I began looking for insurance for my new home, I am getting denied due to the claim on the home we had together is less than 5 years old.
    Do you have any suggestions on insurance companies that will cover me? I live in Indiana.
    Why are insurance companies denying coverage because of a claim? Isn’t this what insurance is for…to cover things like this.
    Thank you!
    Darla

  614. August 2nd, 2011 at 12:00 pm #Anthony

    We had a storm one night and the next morning my heat pump would not work. I was told to get a contractor to say that lightning ran in on it and send up an estimate. Two separate guys looked at it from Trane and wrote a statement saying hit by lightning. Now my insurance company has had 3 of separate people of their choosing look at the heat pump and ordered a lightning report. We keep jumping thru hoops and its been 3 weeks in the July heat and still nothing. What is the problem? Thanks.

  615. August 2nd, 2011 at 12:18 pm #Kelly

    Roofing contractors just want to see your insurance papers and will magically repair it for exactly what the insurance paid plus your deductible. Since my insurance carrier does not require that I submit bids, what’s the best way to approach contractors without turning over the insurance papers to them?

  616. August 2nd, 2011 at 12:31 pm #Kari

    Call and get estimates. You don’t have to show the contractor anything to get an estimate and you shouldn’t have to show your insurance company an estimate to get the money they agreed to pay per their estimate. However you won’t be able to collect any additional money that you are not out. We got several estimates prior to our adjuster even coming out.

  617. August 2nd, 2011 at 4:00 pm #Jason

    Anthony,
    There doesn’t appear to be a problem. What your insurance company is attempting to do is to determine why your heat pump failed. The information provided by the Trane individuals may not have been convincing. Insurance will only pay when there is a covered loss. If a heat pump fails during a storm does not automatically mean it was damaged by lightning.

  618. August 3rd, 2011 at 6:48 am #Anthony

    Jason,
    I dont have a problem with that, its just that even if it was a power surge of some kind it is still covered under the policy and Ive seen the pump and it is burnt up. There have been 5 other people in my town with the same claim and its been fixed by other companies no questions asked. Thanks for the insight and information.

  619. August 3rd, 2011 at 11:51 am #admin

    Anthony,
    Why not help other consumers, give 2 minutes of your time and rate the adjuster and insurer on our Rate Your Adjuster page. You don’t have to give your real name if you fear them.

  620. August 3rd, 2011 at 12:40 pm #Desiree

    We have Homesite by Progressive for our Insurance and live in WI. We filed a claim due to a torndao on June 21, 2011. We have been fighting with our Claim Associate and Adjustor. The largest damage was to our rubber roof which blew off the house and as a result we had water damage to 3 rooms. The first adjustor determined replacement value of roof at $4800. Every quote that we have gotten is $15k or more just for the roof. We have invoked the ‘appraisal’ process and are scheduling a meeting with our contractors and a inspector to meet with the new insurance adjustor. My questions are the following: 1) Where would I find a ‘Code Upgrade/Endorsement’ in my policy? The Claim associate says that it is covered but I cannot find it. 2) What happens when the new adjustors report is submitted for ‘File Review?’ Can they change his assessment? 3) If we (Homeowner & new Adjustor) agree to a dollar amount for repairs to our home, is it a done deal? 4) Can you recommend picking an ‘umpire’ in case the appraisal process goes badly? 5) Is there anything more that I can do??? It looks like I have a day to figure this all out.

  621. August 3rd, 2011 at 2:52 pm #Jason

    Anthony,
    A heat pump is an expensive component. Not all policies provide coverage for power surges. Also, what is the extent of damage? If it is a covered cause of loss, what needs to be repaired? Is it the circulating motor, a fan motor, lines, condensers, etc. Even if it’s covered, there has to be a known scope of what is damaged and what needs to be repaired.

  622. August 3rd, 2011 at 3:06 pm #Jason

    Desiree,
    In your policy, it will be under the topic of Codes/Ordinance but what is more broad are the wisconsin statutes that dictate what can and can’t be done when repairing a home. If a current item on a home is damaged and the codes have been updated, there is a requirement to follow the new codes.

    The insurance company’s contract with you is to repair your damaged property and in order to do that, they need to follow the codes for those repairs. It’s very likely in your policy but what it says is that code updates will be allowed during repairs.

    A rubber roof is basically a rubber roof. If the estimate is for $4800 for a rubber roof and the other estimates are for at least $15,000, it is clear these two roof products are not the same.

    Some people confuse different roof materials and all call it the same. There is rolled asphalt roofing, bitumen roofing, and rubber roofing. The rolled asphalt is the least protective and least costly while the rubber roofing is the most protective and most costly. The bitumen is in the middle somewhere.

    If you didn’t have a rubber roof and your local building code requires that you have rubber roofing when it is repaired, then you need to be able to convince those on the other side of the issue that what you are required to put on is rubber roofing.

  623. August 5th, 2011 at 5:53 pm #thedudeinthetree

    What is the typical depreciation holdback percentage on contents? Does it vary by insurer/adjustor/or by condition of items in home?

    Thanks

  624. August 5th, 2011 at 6:38 pm #Jason

    thedude,
    It varies by insurer, adjuster, and condition of the items. Another factor is that it is based on age too. You can be looking at between 0-100% depending on the factors involved.

  625. August 8th, 2011 at 7:17 pm #Wendy

    I had a piece of jewelry that I thought had been stolen, although I wasn’t sure. My insurance had a rider for jewelry and I made a claim and replaced the piece. Now it has been found and I have two of the same thing. What should I do? Do I report this? Try to sell the piece and reimburse the insurance company? What?

  626. August 8th, 2011 at 8:59 pm #Jason

    Wendy,
    What has happened is the insurance company replaced the piece of jewelry for you. Their action of replacing it places them in the position of rightful owners of the piece of jewelry that was stolen (lost or misplaced).

    The insurance company fulfilled their portion of the contract by replacing that piece of jewelry based on the presumption that it was lost or stolen. Your obligation at this point is to let them know of the circumstances. They will likely ask that you send the found piece of jewelry to them so they my sell it as salvage.

    It happens that jewelry is misplaced and a claim is made because it cannot be found. Your situation is not unique. Just call the insurance company and let them know and ask them what you should do. They will provide you with the appropriate information to take care of this.

  627. August 10th, 2011 at 11:04 pm #J.J.

    Am I required to provide the claims adjustor with a requested copy of the home inspection (for the lender) I got 9 months ago when I bought the house. I think they will try to find a way to use it against me.

  628. August 11th, 2011 at 1:01 pm #Jake

    Finalized divorce. Ex got house but let it foreclose with my name still on note. Name also on ins. policy. Sheriff sale scheduled for next week. Wind blew fence down last week and ex made ins. claim. I spoke to the adjuster and was told her claim will affect me. Who has a right to the ins. proceeds?

  629. August 11th, 2011 at 2:17 pm #Sean

    Neighbor’s AC caused a big leak in one of my basement’s rooms.
    Had to change floors and paint walls. When water remediation people pulled baseboards off they saw mold had been growing for a while, so there was leakage for a while which ended in a big gushing leak.
    We filed a claim with our insurance and he filed acclaim with hiS, but his insurance won’t pay ours because they say he is not negligent because he didn’t know about the leak.
    What can we do to recover our deductible?
    Can we sue him in small claims if insurance companies can’t sort it out

  630. August 11th, 2011 at 2:27 pm #Jason

    J.J.
    You don’t have to provide the inspection to the insurance company if you don’t want. That was something required for financing, not insurance. If you believe they will use it against, you don’t share it. If you didn’t get one, they would have to pay for one just like you did so don’t let them overlap the finance agreement with the insurance agreement.

    I don’t specifically see why you don’t want to provide it. But, then again, I also don’t see their need for it. You can politely decline to provide it and ask them specifically what it will do to help them with insurance? If they have no reason for it, then they just answered their own question.

  631. August 11th, 2011 at 2:33 pm #Jason

    Jake,
    How ever the names appear on the insurance policy. Generally the first named insured has more rights, like the ability to change or cancel the insurance, but the proceeds from the claim should include the names as they are listed on the policy.

    It is possible that your wife could get the check without your name on it but that is quite a hassle and would require sending a lot of information to the insurance company and having the insurance company agree that it should be made out without your name. Also, it will definitely include the lien holder’s name on the check too. Especially since it’s in foreclosure.

  632. August 11th, 2011 at 2:39 pm #Jason

    Sean,
    Your neighbor isn’t negligent. If he is not negligent, their insurance won’t pay for your damages. Also, they won’t pay for your deductible. You won’t be able to recover you deductible just like your insurance company won’t be able to recover what they paid out for your damage.

    If you sue your neighbor, you will have to prove to the judge that your neighbor was negligent. Since that is the required burden of proof to succeed, you won’t succeed because your neighbor is not negligent.

    Your best bet would just be to ask your neighbor to reimburse you for your deductible. He might or he might not. That would be your best option to recover your deductible.

  633. August 11th, 2011 at 2:45 pm #Sean

    Jason,
    Why is he not negligent if I can prove the mold growth was weeks old?
    Shouldn’t ge have realized at some point that there was a leak?

  634. August 11th, 2011 at 4:31 pm #Jason

    Sean,
    Please dont’ take this to be legal advice. If you can prove that mold growth was weeks old, you would likely need to have an engineer to support that finding. Let’s assume that the mold is 3 months old. Now how does that tie your neighbor into your damage? Remember that negligence is based on what a person does or does not do that causes damage.

    No he shouldn’t realize there is a leak at some point. People don’t assume anything is wrong with their AC unless it’s not working. Since in your earlier report, the neighbor did not know about the leak, he did what a reasonable person would do in that circumstance which is nothing. It’s very difficult to prove what someone knows or doesn’t know unless they come out and admit it. Do you have a way to prove that your neighbor knew this was happening (before it was discovered) and your neighbor did nothing about it?

  635. August 17th, 2011 at 9:23 am #charleen

    Can I file a claim for a broken sewer pipe? I have a sewer pipe that is leaking raw sewage into my basement. Im not sure of the cause, but it is completely blocked, we have rented the machinery to clean the clog but nothing has worked so far. I have never filed a claim before, so any info would be greatly appreciated! My tenants are threatening to sue if it is not fixed soon. We also have a disabled child in the house. Im from Massachusetts and have Massachusetts Fair Plan. Thank you!

  636. August 17th, 2011 at 10:43 pm #Devi

    My house caught on fire 1/15/2011 and I had my insurance company come out American Family Insurance, they referred me to a restoration company. Well that restoration company has only completed the rough ins and have received $65k from my insurance and to this day have not completed the work. The owner is ignoring my calls, only when it came to the money he would call me to make sure he got it but never did anything. (I am aware now that I am not the only one this restoration company has done this too, who can I report them too for fraud and running off with my money and other homeowners’? he also closed his business so they no longer exist) it is now August 2011 and my house is no where nearly complete and the insurance is saying that i have passed the deadline, but I had no control over the work being done, I was getting the run around from the restoration company the owner never answered my calls. Is there anything I can do? I have 6 kids and have been evicted from the rental home the insurance was paying on. I don’t know what to do.

  637. August 17th, 2011 at 10:45 pm #Devi

    sorry forgot to tell you I am from Illinois.

  638. August 18th, 2011 at 6:01 am #Jason

    Charleen,
    File a claim. We are not able to determine if something is covered from you explaining it on-line. Perhaps when the adjuster is out, they can determine what is wrong and what needs to be done to remedy the situation. Regardless if this is covered by insurance or not, you need to fix what is wrong.

  639. August 18th, 2011 at 6:13 am #Jason

    Devi,
    You have control over the restoration company. They are hired by you and nobody else. Sure, you may have gotten their name from the insurance company but you are the one that hired them.

    As for the money, the work should be completed to a certain stage before the restoration/contractors get paid for the work. They should not be getting paid before the work is completed.

    If you need to get a different contractor in there to do the work, that is what you need to do. I don’t know the extent of the damage or the time frame given to you to get the repairs done but if the insurance company indicates you have taken too long, then the work should be completed by now. I don’t know how much more funds you have left or how much more the insurance company is going to pay but you need to get someone in there that can get this work done and get it done in a timely manner.

    As for the rental home, the insurance company has nothing to do with an eviction. You may need to call your insurance company and indicate to them what is going on to see if they have any suggestions for you.

  640. August 18th, 2011 at 10:12 am #Steven Powell

    I filed an renter’s surance claim more that two months ago. My company (Amica) wants me to alk to their attorney after i met with an investigator representing their company two times for extensive interviews. What can iIdo? I feel another interview and delay of my claim is unreasonable.

  641. August 18th, 2011 at 10:48 am #Lianna Bodine

    My father passed away a year ago and we are working through liquidating his estate. We were set to close on his cabin set on a Federal Land Lease tomorrow for $120,000 and the cabin burnt to the ground (total loss). He had it insured for dwelling $85,000, contents $69,000 and loss of use $17,000. The adjuster is willing to give us $85,000 for the cabin, but won’t give anything toward loss of use, and he hasn’t disclosed contents. We are unsure if the Forest Service will let us rebuild, and if not, we will be required to tear out not only the damaged home, which the insurance co has allowed $4000 for, but also the septic tank, well, dock, shed etc. Our cost will far exceed the $4000 and we will no longer be able to use the property. Do we have any arguement for loss of use? In a total loss fire, do they give your the insured content amount or do we need to itemize. No one in my family has been in the cabin for over a year so the “handy man” filled out a content list with only 30 items listed. Thanks for any advise.

  642. August 18th, 2011 at 12:07 pm #Jason

    Steven,
    It’s required for you to make it through the claim process. Whether you think it’s a delay or not, that is something you are required to do if they request it.

  643. August 18th, 2011 at 12:11 pm #Jason

    Lianna,
    These questions are best suited for your adjuster. Ask him what they will allow for loss of use, how long they will allow that, and what dollar amount. If there are personal items besides the ones your handy man listed, then do an inspection and present that information to your adjuster.

    The insurance doesn’t guarantee that you will be able to continue to use your land, it insured the building, contents, and loss of use. If you need to remove the septic tank, well, dock, and shed, those items will be at your cost because they likely were not damaged as a result of the fire. If they were, then the insurance should be addressing those items as well.

  644. August 19th, 2011 at 6:41 am #Carla

    What happens if you lose a piece of jewelry and the ins co reimburses you for it under homeowners and then you find it 3 years later? Should you turn the jewelry in to ins. co?

  645. August 19th, 2011 at 7:25 am #Jason

    Carla,
    That is what you should do. Perhaps a call to them first to find out exactly what they want you to do with the found piece of jewelry.

  646. August 19th, 2011 at 8:05 am #craig

    Dont feel bad, my heat pump estimate was $5900 and I have a 500 deductible. The insurance company sent me a check for only $2000. Now that is a rip off.

  647. August 19th, 2011 at 9:18 am #Jason

    Craig,
    We don’t feel bad. We don’t know the detail of the estimate, nor what is required to fix your heat pump. We cannot confirm it’s a rip off when we don’t know the details. I have to assume since you have a $500 deductible, the total of $2500 should fix what was covered by insurance. Let us know if that is correct.

  648. August 19th, 2011 at 10:43 am #Marissa

    My family and I have been out of our house for about 3 weeks due to water damage. We’re at the point in our claim where AAA has given us an amount for the settlement based on their adjuster. The $ amount they gave us is low for the damage that has been done, therefore we had a general contractor come in and estimate. We sent the proposal to AAA and now they want a more detailed estimate from the contractor since the contractors estimate is higher. In the mean time, the insurance agent said he is going to send out the check for the amount their adjuster estimated. By him sending the check, does this mean there is no negotiating the settlement afterwards? Or there is? Are we waiving any rights by AAA sending the check. I heard the insurance companies underestimate and the home owners end up having to pay more for the repairs.

  649. August 19th, 2011 at 10:51 am #craig

    I feel bad though. MY heat pump was covered by peril. Estimates showed 5900 damage but insurance paid 2,000. There isnt anywhere I can get a heat pump for 2500. The whole system was fried so who knows where the 2500 came from, just pulled out of the air. Thats the way it is nowadays though. Peace.

  650. August 19th, 2011 at 11:05 am #Jason

    Craig,
    Again, we don’t know the details of your claim, the damage, or any information on the estimates. Apparently the heat pump can be repaired but that is only an assumption. The good thing is that if the $2500 doesn’t repair it is that there can be a supplement added for any additional costs that are needed above the $2500 amount. I would be glad to compare the estimate for $5900 and the one for $2500. There may be things in the $5900 estimate that is not needed or unrelated to the damage for your claim. Again, we don’t know. If you want you can forward the estimates to me at kroll.ron@gmaill. com so I can review. You have my have raised my interest in the difference. Thanks.

  651. August 19th, 2011 at 12:02 pm #JesseeTidwell

    i think jason is a company man…lol

  652. August 19th, 2011 at 1:37 pm #Jason

    Marissa,
    If everything is accounted for in the estimate, then the estimate should be adequate. The general contractor will have to provide more details in his estimate for the insurance company to be able to evaluate the difference. The check should not waive your rights to have all the covered parts of your claim covered.

    A supplement can be forwarded to the insurance company for payment if things that should have been addressed in the estimate were not originally accounted for.

  653. August 19th, 2011 at 5:15 pm #JACK

    I RECENTLY HAD A CLAIM AND SETTLED WITH UNIVERSAL. I HAVE SINCE FILLED A CLAIM FOR LOS. HOW DO I CLAIM LIVING IN ANOTHER HOUSE WE OWN THAT IS SUPOSSED TO RENTED OUT AS A EXPENCE.
    THANKS

  654. August 20th, 2011 at 5:40 am #Jason

    Jack,
    The house that you own and lived in had you in it so could not be rented. Simply present that information to the insurance company. Support the amount you claim for living there by providing the insurance company the documentation of how much you received in the recent past that others have paid for rent to live there.

  655. August 21st, 2011 at 3:10 am #Gerry

    On August 13th, my house was struck by lightning and caused a house fire that made the residence uninhabitable. The emergency crew the insurance hired came out that night and tarped the roof and boarded the windows. It wasn’t until I had to fax a supervisor that the insurance sent out an adjuster and restoration crew on August 19th. The adjuster told me he was midclaims and they would have to send out a large claims to handle my claim. The restoration crew removed all the hardwood and carpets. I live in a 2 story house and because of the water damage, the celing has been falling daily onto the first floor. My hardwoods have been covered in wet insulation. Nothing in my house has received any preventive maintaince against the water damage. Is the insurance reliable for the long wait in getting an adjuster out to the premises and can I demand to have the entire house gutted to prevent mold?

  656. August 21st, 2011 at 8:48 am #Jason

    Gerry,
    The insurance company is responsible for the time it takes to get the adjuster out there. There has been immediate damage to you home. Because of that immediate damage to your home, other damage will arise or become worse. That is all part of what needs to be addressed by the insurance company when it settles your claim.

    You can demand anything you want. Whether the insurance company does it will be up to the adjuster. You as the homeowner and insured, have the responsibility to mitigate the damage to your home. If you are not getting the appropriate direction from your insurance company, you will need to take the lead and take property saving actions.

  657. August 21st, 2011 at 2:38 pm #Tanya

    Hi,

    We have water coming into our converted room that used to be part of the garage everytime it rains. My mom wants us to call the insurance company. How do I word my claim so that they don’t drop us from coverage?

  658. August 21st, 2011 at 6:49 pm #Jason

    Tanya,
    Tell your insurance company that you have water coming into your converted room that used to be part of the garage every time it rains. They shouldn’t drop you for making a claim. If they do, find a different insurance company.

  659. August 22nd, 2011 at 9:05 am #Cajunell

    I suffered a loss off my home due to fire in August 2010. My insurance company assessed the damage and settled my claim for the maximum amount allowed by my homeowners’ policy. I endorsed the initial insurance check and forwarded it to the mortgage company (US Bank) along with documents they required to be filled out and signed by my contractor. The initial draw (1 of 3) was forwarded to me and signed over to my contractor. The mortgage company required an inspection at the 60% complete mark in order to release the 2nd of 3 draws. The inspection was down over 3 weeks ago and the 2nd draw has still not been released. I have called and literally been on hold for an hour before speaking to anyone. Every time I call I get a different person on the phone. It does not appear that my filed has been “assigned” to anyone in specific to handle. Construction has haulted on my home for the last 2 weeks. My contractor is out of pocket $25,000 and I am out of pocket $28,000. Is there a legal time limit that the mortgage company can hold your insurance proceeds during the construction process after you have meet all their necessary requirements. I am at the end of my rope. We have now gone over our limit for loss-of-use on our insurance policy and have to pay $2000 in rent next month and a $1600 house payment. I live in Louisiana and the mortgage company is US Bank.

  660. August 22nd, 2011 at 1:29 pm #Jason

    Cajunell,
    Your situation is related to banking, not insurance.

  661. August 23rd, 2011 at 6:44 am #Dena

    We’ve had an extended drought here in Texas. We’ve kept soaker houses around the slab foundation going to keep clay soil from shrinking from the foundation.
    However, we have noticed the interior walls are separating from the floor and it appears the center of the foundation is cupping. We have a limited slab or foundation access endorsement on our policy. Is foundation damage due to this drought covered by our homeowners policy?

  662. August 23rd, 2011 at 11:07 am #Jason

    Dena,
    I am not familiar with the limited slab or foundation access endorsement but it sounds like that endorsement is to open up or gain access to something damaged (like pipes) within the foundation or below the foundation.

    A drought is an event that occurs over time and although the condition of the foundation and walls is accidental, it doesn’t appear to have the element of sudden.

    The only way you will know is if you present a claim for the condition of your floors and walls.

  663. August 23rd, 2011 at 6:34 pm #Charlene

    It has been a long process but finally we received the word that our insurance company is covering our vacation home for the water and mold damages we found this spring. Now as we have had the opportunity to relax and start through with the rebuilding process we now are at another snag. It seems after the water and mold removal as they prepared to start the rebuilding of our home they found out the water damage has caused a problem with the foundation. My question is my insurance company has allowed and authorized the general contractor to call in a foundation specialist for an estimate which sounds great. So here is my dreaded question…is there anyway they can legally back out and refuse to remedy this so we can’t proceed with the prior authorized repairs? I guess I assumed since the water damaged the home and they are fixing it why wouldn’t automatically the damage the standing water caused to the foundation be a go ahead?
    Any advice would be appreciated…I have felt so stressed over the past 4 months since the problems initial discovery…the waiting to find out it would be covered was horrendous and now this hiccup in the painful process is overwhelming to say the least…Truly sleepless here in Seattle.

  664. August 23rd, 2011 at 7:45 pm #Jason

    Charlene,
    If they are having the foundation checked by a foundations specialist, that should not affect the other parts your claim – just the foundation. You should be fine with the repairs they already authorized.

    As far as the foundation, not much, if anything will be included in that for water and mold damage. I don’t know what the foundation issues are but water generally won’t affect a foundation. Good luck in the repairs.

  665. August 23rd, 2011 at 8:24 pm #Charlene

    Thanks Jason,

    I do appreciate the feedback, but with no other issues going on I must say that I firmly believe it was the pooling of the leaking water which created this foundation problem. I hope the specialists are able to concur and make that connection because in the “perfect” world I would find this also included under my claim. I certainly need to believe its possible.
    Thanks again,
    Charlene

  666. August 24th, 2011 at 12:10 pm #Shay

    Hi, I have a brand new home buillt in 2005 and have been living in it for 4 years. I filed a claim 2 months ago for water damage in my kitchen ceiling, and was told that water came through the outside vent and was paid a check for plaster and paint only, pipe and plumbing is not covered. The problem is that we had more rain and now my son’s room also has water damage. My question is can I file another claim for this? and if so will my home insurance go up?

    Thank you.

    Shay

  667. August 24th, 2011 at 12:16 pm #Jason

    Shay,
    Call the insurance company and let them know that you discovered more damage relating to the water that they did not address. Ask them to come out and re-evaluate the claim so it is all encompassed under the original claim.

    Claim frequency can make a premium increase.

  668. August 24th, 2011 at 12:50 pm #Michelle

    We were in tornado in Missouri. We had a previous claim on roof 6 years ago for hail damage. Adjustor says it doesn’t look like roof was redone at that time because vents look the same. Can they subtract off the previous claim?

  669. August 24th, 2011 at 2:07 pm #Sally

    Is there an obligation to replace contents at the lowest possible price? Everytime we replace some of our contents the adjuster sends us a quote from a cheaper store and says he’ll only pay that amount for replacement cost. We’ve already put out a higher amount for our furniture, appliances and electronics. I don’t feel that’s fair.

  670. August 25th, 2011 at 1:02 am #Yelkitza

    I own a rental duplex in Anch. AK. My next door neighbor refuses to remove 3 large trees that are on his property. The roots have been traveling towards my foundation so I hired and paid a handy man twice to remove roots from my side of the property. Trees are on his property but 12 feet from my foundation about 10 feet from his foundation.
    My question to you is, (1) would my neighbor be responsible if his trees fell on my duplex? (2) is he responsible if his trees roots cause problems to my foundation -sewer lines – water lines or would this be “the act of God” like my neighbor is saying? He said that he will remove the trees if I pay for half of the cost, if not, the trees stay… Like I said, the trees are on his property.
    Yelkitza, WA

  671. August 25th, 2011 at 11:25 am #Theresa

    my house was on fire on the 9th of June, my son was accused of putting the house on fire. Now the insurance company are refusing to pay for the house. Is it right for the insurance company to refuse to pay for the damage caused in the house?

  672. August 25th, 2011 at 6:48 pm #Jason

    Michelle,
    Yes.

  673. August 25th, 2011 at 6:53 pm #Jason

    Sally,
    This adjuster seems to be a bit picky. You should be able to replace something locally with minimal delivery costs and whatever that price is should be what is allowed. Technically, you don’t have to replace it with the cheapest and this adjuster should be a little more flexible.

    Now, if you are talking about replacing a 32 inch flat screen with a 40 inch flat screen, the allowance should be for what the 32 inch flat screen costs.

    Talk to this adjuster’s supervisor and express your concerns to that manager.

  674. August 25th, 2011 at 6:58 pm #Jason

    Yelkitza,
    It doesn’t matter whose tree falls on your property. That is why you have insurance. He is not responsible if his tree does damage to your property whether from the branches or the roots.

    This also is not an act of god because trees grow taller and their roots expand out and downward. That would be an act of nature.

    Now, if he is offering to remove the trees if you pay half, that seems to be a reasonable compromise.

  675. August 25th, 2011 at 7:02 pm #Jason

    Theresa,
    There is such a thing as an innocent insured and there has been case law involving one spouse burning down the house and the other spouse being able to collect for their ownership interest in the house. It has not always been like that. This involves your son and there is a difference between your son intentionally burning the house, intentionally burning something and the fire getting out of control and burning the house, or your son accidentally burning the house. We simply don’t have enough information and if we did, we likely would not become involved. This is really something for an attorney to be involved with.

  676. August 28th, 2011 at 6:08 pm #Chad

    My house is a total loss due to fire. I do not want to rebuild but was informed that I would lose a substantial amount of what the insurance would pay by not rebuilding. Can anyone give me a ballpark percentage on how much insurers deduct for not rebuilding? Thanks for any insight!

  677. August 28th, 2011 at 6:41 pm #Jason

    Chad,
    Why don’t you ask them? They would probably pay you ACV for your house which is the replacement cost of the home less the home’s depreciation. We don’t know the age of your home so it’s very difficult to give you a percentage.

  678. August 29th, 2011 at 9:03 am #Ed Clark

    We have Allstate and are being informed that the damage in my basement due to the sump pump not operating because of power failure is not covered. some friends have told us that they cant turn down the claim due to that there was a state of emergency declared in my state due to Hurricane Irene. Are there any grounds to fight Allstate since i have an estimated 5-6 thousand dollars in damage in my basement.

  679. August 29th, 2011 at 4:42 pm #Jason

    Ed Clark,
    Sump pump overflow and sewer backup are excluded from you policy unless you specifically add that coverage to your policy and it would be called a Sewer Back Up/Sump Pump Overflow Endorsement.

    Your policy likely has wording very similar to this:
    Water Damage Water Damage means:
    c. Water or water-borne material below the surface of the ground, including water which exerts pressure on or seeps or leaks through a building, sidewalk, driveway, foundation, swimming pool or other structure; caused by or resulting from human or animal forces or any act of nature.
    Direct loss by fire, explosion or theft resulting from water damage is covered.

    It may even specifically state that Sewer Back Up/Sump Pump Overflow is excluded.

  680. August 30th, 2011 at 2:55 pm #Tanya

    On June 1st 2011 Rent a Center installed a washer in my new construction home we had moved into in January 2011. The installer did not put the drain hose in the drain pipe but left the drain hose on the floor under the washer. My husband started a cleaning cycle on the washer (this was our washer that had been away being repaired for over 4 months). A clean cycle fills the entire washer with bleach water and then allows that water to sit. Once the cycle is complete it drains all the water. Because the hose was not properly installed all water drained into the hall and down into the basement. We have a ranch home so Service Master found water in all three rooms and clear out into our living room. Service Master pulled the carpet up to dry the carpets and the floor. Here it is 3 months later and we are still fighting with the insurance company. The carpet was damaged and the insurance adjustor that finally came out a few weeks ago said that all carpet should be replaced. It has been over 30 days since we heard anything from the insurance company. I sent an email two days ago demanding a response but have yet to receive anything back. What can I do to force this insurance company to resolve this issue? What type of lawyer would I seek if this has to be taken to that level. Our homeowners insurance (state farm) will come in and replace the carpet but then we have to pay our high deductible and wait for the lawsuit to be settled with the insurance companies before receiving that money back. Can some type of mediation help bring this issue to a close? Any advice would be greatly appreciated.

  681. August 30th, 2011 at 3:49 pm #Jason

    Tanya,
    Have your insurance company come in and replace the carpeting and pay your deductible. I’m sure it’s not any higher than you selected it to be when you got your insurance with them.

    There won’t be a lawsuit between the insurance companies. If there is a disagreement whether the RAC insurance company is liable or not, it will go to arbitration and be settled there. If your insurance company is successful with the arbitration, you will likely receive your deductible back from state farm.

    You can’t force the insurance company to do anything. You have insurance and that is what you can do right now. You would only muddy the waters if you sued the RAC insurance company. Not only that, you would be spending money with an attorney that you will likely never see again.

  682. August 31st, 2011 at 7:26 am #Bridget

    Hello. We had some water damage to our house from the driving rains in Hurricane Irene. The interior damage is minimal and our insurer said that it would definitely be covered. We don’t know to what extent the roof is damaged but it was in need of replacement before the storm hit.

    The insurance company wants us to get a roofer to come out, inspect the roof and send them a report. We’re afraid that the exterior damage won’t be covered if a roofer reports that the roof needed replacement in the first place.

    How should we proceed with a roofer to make sure that the insurance company will cover some of the roof repairs?

    Thanks!

  683. September 1st, 2011 at 5:24 pm #Jason

    Bridget,
    The insurance covers your roof regardless if it is brand new or 50 years old. If the roof is doing it’s intended function before the loss, you should have no worries. The roof was doing it’s job and now it’s damaged. That is what insurance addresses.

  684. September 1st, 2011 at 5:40 pm #Les

    I have State Farm homeowners insurance in Maryland. What does endorsement FE-5480 Amendatory Debris Removal cover?

  685. September 2nd, 2011 at 1:57 pm #Jason

    Les,
    This endorsement changes some definitions of your policy and changes your coverage relating to debris removal. I don’t have access to view one of those endorsements and it is likely related to a state, county, or city ordinance that describes how and what you have to do with debris if it meets certain conditions.

    You should have a copy of this endorsement so you can read it and try to understand what it changes. If you don’t have a copy, get one from your agent. Perhaps your agent can explain it to you in layman terms.

  686. September 3rd, 2011 at 11:45 am #Neal

    We had water damage in our basement due to the sump pump not being operable during the power outage, all of the carpeting was soaked as well as the bottom of the drywall and insulation. We already have an estimate from a trusted contractor to remove the bottom 24″ of dryway and insulation and replace, I removed all of the carpeting immediately as it began to smell of mildew. I have 5k of sump pump overflow coverage on my NJ Manufacturers policy, we have an inspector coming out tomorrow. I also have 10k of mold/fungi/mildew coverage which kicks in if a covered peril causes mold, my logic is that the sump coverage is a covered peril therefore the mildew coverage should also kick in. My hope is that I can collect the 5k sump pump and 10k mildew coverage as my damages will total 15k with carpet replacement and drywall. I see in the policy that the sump endorsement does say it will not kick in as a result of a flood, but flood is not a defined term and the water came in due to the inoperative sump. I am correct in my thinking that I can expect the 15k provided the insurer agrees that I would have mold problems if I left the drywall in place.

  687. September 9th, 2011 at 12:40 pm #Jason

    Neal, if you have mold because you would leave the mold in place, you are not adhering to the conditions of the policy that indicate you have an obligation to reduce or minimize the damage. So, if you left the drywall in place to mold, then you are intentionally allowing a loss to occur. Don’t count on that $10,000 mold for any part of your claim. That is not how the policy works. You can count on $5000 and they will probably also absorb your deductible (meaning they won’t reduce the $5000 by your deductible amount.)

  688. September 10th, 2011 at 9:00 pm #Jennifer Cooper

    Hi, last week my kitchen caught fire due to a grease fire. One side of my kitchen is burnt up but the other side was untouched. Will the insurance pay to re-do the entire kitchen so the new cabinets and counter tops match the other side? Also, all the insurance adjuster said was that he was sending a contractor to get a better estimate, but what about personal items that were lost, like groceries, rugs, curtains, blinds etc…

  689. September 11th, 2011 at 12:37 pm #Rob

    My contractor agreed to an xactamate scope and price for my damaged home. In xact the materials and labor are broken down. Is my contractor required to pay a sub the labor money that he received for those line items from the insurance company. Ex. the contractor receives 1000 in labor for drywall yet he only pays the drywall sub 500 in labor. Does he owe the insurance company the 500 balance?

  690. September 11th, 2011 at 3:53 pm #Jason

    Jennifer,
    The insurance company and your contract is to repair the direct damage. If it is not damaged, the insurance company doesn’t have to cover it. And insurance companies don’t owe to match what you have.

  691. September 11th, 2011 at 3:54 pm #Jason

    Rob,
    What is likely gonna happen with that $1000 in your example is that he will pay the drywall guy $500 and he will keep the other $500. The insurance company isn’t going to get it back.

  692. September 11th, 2011 at 6:42 pm #Jay

    I have a few questions regarding BSREL (Building Structure Reimbursement Extended Limits)coverage. From what I understand of this, I am entitled to an extra 20% of my policy limits, IF my costs to rebuild exceede my regular policy limits. How does this work? Do I have to spend the $ to get the $? Or, can I exhaust all policy limit monies and report to the insurance company that I need my extended limits to complete building? Should i provide my insurance company/adjuster an estimate that reflects the need for the extra 20% during negotiation?

    How does BSREL come into play in regards to building a different, bigger home than what I had originally had? If the insurance company sees that I am building a larger home that exceedes the cost of what it would cost to rebuild my original home to pre-loss condition, am I still entitled to BSREL for the remaining costs to finish the larger, more expensive rebuild?

    -Jay

  693. September 11th, 2011 at 6:43 pm #Jay

    Hi,

    I have a few questions regarding BSREL (Building Structure Reimbursement Extended Limits)coverage. From what I understand of this, I am entitled to an extra 20% of my policy limits, IF my costs to rebuild exceede my regular policy limits. How does this work? Do I have to spend the $ to get the $? Or, can I exhaust all policy limit monies and report to the insurance company that I need my extended limits to complete building? Should i provide my insurance company/adjuster an estimate that reflects the need for the extra 20% during negotiation?

    How does BSREL come into play in regards to building a different, bigger home than what I had originally had? If the insurance company sees that I am building a larger home that exceedes the cost of what it would cost to rebuild my original home to pre-loss condition, am I still entitled to BSREL for the remaining costs to finish the larger, more expensive rebuild?

    -Jay

  694. September 12th, 2011 at 4:38 am #Don

    I have Allstate and am in NJ. I have no additional coverages beyond Homeowner’s. I had water in the basement as a result of a door being damaged (glass pushed out). Door is partially below ground level and faces east and winds were from the east during the hours Irene was upon us. Is there any hope my policy will cover?

  695. September 12th, 2011 at 8:50 am #ames

    needing advice on how to deal with our insurance company – my father and sister were murdered in the home owned by my father, the house was set on fire and burnt to the ground. The only thing left standing were 3 wall of the basement. He had homeowners insurance and my name was listed on the policy.

  696. September 12th, 2011 at 11:37 am #Maggie Mae

    I have an HO5 insurance policy with Cincinnati…..we had F1 Tornado winds where we live in April of this year..the roof was new in 2008..we
    had no leaks until this April….we noticed in June of 2011 that the wall paper was peeling up high near where the roof meets the outside wall of our downstairs bath. Discoverd water in the wall and some siding damage
    to the outside wall…Insurer says they will cover the inside, but had Donan Engineering firm come out and they determined some shingles were not
    sealed well and tried to say it was from the laying of the roof…well, for almost 3 years, there was no damage to the walls untill this F1 went
    through the neighborhood, took down 80 trees, sucked water out of a neighbor’s swimming pool and others lost shingles..they are saying if it was the F1, it would have taken the whole bunch of shingles and not just unsealed them….I say it could have blew them loose without them flying off…what say you? Thanks…

  697. September 12th, 2011 at 1:01 pm #fslapar

    I have had issues with water seeping into my mostly-finished, partially below grade basement since we moved into our house 3 years ago. During the recent heavy rains from Irene and Lee, the seepage got worse (water was spraying out of the wall, about 5” above the basement floor like a water-balloon with a pin hole in it) and so I decided to file a claim. The claim was denied because ground water entering the house is not covered.

    Am I correct to assume that this claim would have been covered had I had flood insurance? If I purchase flood insurance (say, tomorrow) and file a claim later on, since this is an ongoing water problem, what are the chances the claim will be accepted?

    Thanks for reading.

  698. September 12th, 2011 at 2:33 pm #Carol

    I live in Kansas.Almost three years ago,I was robbed and almost beaten to death. I was hit in the head three times with an axe and numerous other places,broken jaw,nose,arm,two steel plates in my jaw, and five in my cervical spine, plus many more injuries. I was told they lost me once in the air ambulance,and three times in surgery. I was in a coma over a month.paralyzed face,because of all the injuries and nerve damage,my mind and memory was messed up for a long time. Due to the brain injuries,I never even thought about my homeowners insurance, until one of the court officers brought it up. This happened in September of 2008. I did not file a claim on my stolen items until October of 2009. The second time the insurance company called me, I explained about the pre-meditated first degree murder attempt,and trouble with my mind, and memory. The insurance company told me they never received my first claim, so I could resubmit it and not to worry about the receipts,there was a message that said all their conversations were recorded,) so just send pictures,which I did,as the sheriff’s department had taken many pictures of my slashed up clothes that weren’t taken, things that can never be replaced from my son’s dad, shoes,etc. I told the agent I talked to,it might take me a while,as I still have trouble remembering to do things,she told me not to worry about it,just try to get it in in the next few months,which I did.I sent it in in the last part of August,but forgot to certify it. My sis asked me if I certified it,which I’d forgot to,so I called my insurance agent and he said he still had it,so my sis took me over and I took it across the street to the post office and did it right. I went to the post office on September 2,2011 and had it certified. I was already on permanent disability ($674.00) when I was attacked, and have to replace my clothes,shoes, as my attackers partner was his daughter and my size and was left in my house that night.Am I still eligible for my homeowner’s insurance? I have lost almost 70 lbs. and sure can’t afford to replace my clothes or wear the pair of shoes she left.Thank you and God bless you.

  699. September 12th, 2011 at 3:44 pm #jane fite

    We have a cabin on a lake and a basement bedroom. The floor joists gave way and floor fell in one corner at least a foot. Upon tearing up the floor, we discovered the floor joists had been wet and that section of flooring were rotten. Our homeowners policy shows coverage included in our policy – Property Coverage Limitation for fungi, wet rot, dry rot and bacteria resulting from a covered cause of loss; limits $14850. I don’t know what this means but we have a serious problem. Do you think we could submit a claim for this?

  700. September 12th, 2011 at 8:35 pm #Jason

    Jane,
    Yes, submit a claim for that. We don’t know the outcome of your claim because it has to be investigated first.

  701. September 12th, 2011 at 8:39 pm #Jason

    fslapar,
    This is vegas, so we don’t know odds. If you think you could get coverage for this, spend the premium and find out. If you want to play it safe, just remedy the situation without expecting someone else to take care of it for you. What is the remedy for being in a water saturated area anyway?

  702. September 12th, 2011 at 8:41 pm #Jason

    Maggie Mae,
    I will take the engineer’s answer.

  703. September 12th, 2011 at 8:43 pm #Jason

    Don and Ames,
    File a claim. Contact your agent and file a claim.

  704. September 13th, 2011 at 6:26 am #Maggie Mae

    Jason,
    I am glad to to report that after the engineer checked our roof and determined that shingles in the area where the F1 winds hit at full force had loosened and reported to the insurance adjuster, Cincinnati is going to include all in the fix and it will be covered………. the shingles to be sealed, the outside siding and of course the inside of the bathroom all to be in the claim. This works out well to our satisfaction and speaks well of Cincinnati Insurance. Very informative site here!

  705. September 13th, 2011 at 7:15 pm #wendy kay

    I am a homeowner, I hold the deed and all the proper proof that it is my home, the home was burned down. My mother while she was alive got home insurance on the home and after she passed my step father continued the payments since he has met a woman online and has refused to give us our part of the estate which we were awarded. When i refused to sign over my home to him things got ugly and he sent me a email stated if I was going to be a “B” watch and see what a “B” he would be, needless to say 2 days later the house was burned to the ground and they fire chief ruled it as unknown and closed the case. Now he will receive the money, even though it is my home and my property? how is that fair. I think the fire was set by him I cant prove it, but I am calling the fire chief Monday morning to see if he can reopen the case, I am trying to recover the email he sent showing that there may have been some suspicious intent to recover the money hes out because he wanted me to sign it over so he could sell it? Please help me understand how this is legal? I live in the state of Louisiana so the laws vary. Am I over reacting? So I am thinking if he did get a check from the insurance company is he obligated to repair or rebuild with that money he has possibly gotten from the insurance company? Please help me. Thank you so much for your time.

  706. September 13th, 2011 at 9:52 pm #Jason

    Wendy,
    Whether it’s legal or not, it happens all the time. Yeah, you are probably over-reacting. No, he can take the money and do whatever he wants with it. Why do you care if the case is re-opened. Just move on with your life and stay away from this step father guy. He sound like trouble.

  707. September 14th, 2011 at 4:41 am #Don

    Follow up-

    Claim was filed on the 1rst of Sept. Did not have the ability to use the agent that earns his living off our insurance premiums, as I was referred to an “800” number for filing. Did that and 13 days later, spoke to an adjuster who informed me over the phone, that I had exclusions of drain and sewer that made the claim invalid for my policy. No coverage, and never spoke in person or saw someone from ALLSTATE. I will be contacting my mortgage company to see how they feel knowing such major exclusions exist, and also will try and find out when those exclusions took effect. I was not aware that any major change had taken effect on the policy. Could not get a copy of my policy emailed either. Have to wait 10-12 days for paper version. GOOD HANDS?????

  708. September 14th, 2011 at 4:20 pm #Jason

    Is it illegal in NC to put a “release and payment authorization” on the Proof Of Loss form on a home claim? It states that it would be in full satisfaction and settlement of the above claim. We were told we had to sign this proof of loss form within 60 days or our claim would be denied. There is only one space to sign, so we were forced to sign this release in order to submit our required proof of loss.

  709. September 14th, 2011 at 5:00 pm #admin

    Jason,

    Take a look at these two documents at UClaim.com for some good info on your issue:

    http://www.uclaim.com/docs/img086.gif

    http://www.uclaim.com/docs/img085.gif

    Its a deceptive practice, so that makes it illegal in the insurance code and the business and professions code in most states and probably yours also.

    Wouldn’t it be nice if there was a Federal insurance code so there were not 50 different states with 50 different sets of statutes and case law repeated 50 times? Think of enormous waste of time and money spent on duplicated litigation in 50 states. But hey, this is one way that the insurance industry keeps a grip on consumers. And its a way for most state legislators to get campaign contributions from insurers. It’s a vicious cycle. This is one of those areas where the smoke screen of “states rights” benefits big business over the consumer and small business.

  710. September 15th, 2011 at 6:28 am #matt

    After a tree crushed my garage and tore down utility lines on the back of my lot, I had to spend two days home from work dealing with several utilities crews and boom trucks in my backyard as well as mitigation efforts. Is the time I had to take off from work covered by my insurance?

  711. September 15th, 2011 at 3:30 pm #Tonya Hemsley

    I live in the state of Delaware, I had a house fire on June 3rd of this year. I was assigned a content adjuster and a structure adjuster. The content adjuster was the first one I met, she immediately gave me a debit card with $2500 on it. The Monday after the fire, I met the structure adjuster, he took no measurement, immediately wanted me to go to his car and do a take recorded interview and sign some papers, one asking for permission into my financial world. Of course I was offended. Nevertheless, I cooperated. A month and a half later, they had one of their investigators contact me to do another tape recorded interview, and to investigate, oh did I mention that by the time they send the investigator out, there was nothing in the house, the walls and everything had been removed. He took pictures and then did another tape recorded interview. Now three months later, I recieved money for my structure, but have not recieved anything as far as my property content. But the property content adjuster keeps wanting to give me an advancement. Right now they have had a third party contacting me to find out, if I am going to restore the property. This third party gentleman is a company they hired to help to do the personal property inventory. Oh by the way, the fire marshal ruled the fire as an accidental unattended candle fire. I am at a loss for words. I am in temporary housing, and the third party told me that I only had a year to restore the home. I checked the living expense part of my policy, and it is $200,000, and I am positive that this temporary house I am living in, can only be $2200 a month at most. Please someone advise. I am confused.

  712. September 15th, 2011 at 6:38 pm #Jason

    Matt,
    You policy covers direct damage to your insured property. Your time away from work is not direct damage and is not a covered loss by your insurance policy.

  713. September 15th, 2011 at 6:40 pm #Jason

    Tonya,
    Do you have a question or questions that you want addressed? We don’t just provide random advice. Can you narrow down what kind of advice you are seeking?

  714. September 16th, 2011 at 5:25 pm #Tonya Hemsley

    Sorry, I am just frustrated. My question is, how long does it take to recv’d your inventory list from the content claims adjuster? She also had an external company helping with the inventory.

  715. September 16th, 2011 at 5:26 pm #Tonya Hemsley

    It has been three months, since the fire, and I have nothing as far as my inventory, How should I proceed?

  716. September 16th, 2011 at 10:02 pm #Jason

    Tonya,
    Contact you adjuster and ask that question to that person. They would be able to tell you more accurately than we can. Also, ask you adjuster how you should proceed. They are there to assist you.

  717. September 17th, 2011 at 2:53 pm #shri

    Hi,

    Thanks for putting up this wonderful , very informative resource.

    We live in NJ and had a fire few months back and we are in process of getting final settlement thru appraisal. We have a public adjuster representing us.

    My question is ,can we make changes / additions to the house within settlement amount during repair work ?

    Can insurance company insist on scope of work even if we are within settlement amount ?

    Thanks

  718. September 17th, 2011 at 4:49 pm #Suresh

    I am seeking some help I have had recent hail damage. There is water damage to the garage and couple of other rooms that need drywall repair and paint. Insurance accepted the claim of the internall damage and the drywall repair.

    Because the amount claimed is enough to cover the damages and possible additional stuff. Considering to use for the same property like deck and siding wash and stain. Fixing the fence doors and stain,…

    Adjuster mentioned that i should be getting a check in the mail to start the job and remaining will get upon subbmiting the invoice.

    My question:
    1) Can i use the claimed ampount to the additional work on the same property?
    2) Does the insurance needs the invoice with amount to claim the remaining amount? If that is the case how should i manage my contractor accountable for the additional work?
    3) One of my other property roof damage due to the same hail damage is denied. My contractor insists it should be replaced. What is my next course of action?

    Thanks in advance.

  719. September 17th, 2011 at 10:24 pm #Jason

    Shri,
    If you want to do changes, that should be fine to do just as long as you are essentially repairing the damage in a similar fashion to what is was before. If you have questions about how much modification you can do and still recover the recoverable depreciation, you might want to check with your adjuster to have that clarified.

  720. September 17th, 2011 at 10:30 pm #Jason

    Suresh,
    You really have to follow the estimate to get the recoverable depreciation. However, if your contractor will work from the estimate, and do the additional work on the other items (or however you arrange it with your contractor), you should be fine. Just make sure the outlined work is completed and the dollar amount to do that work was what was allowed in the insurance estimate.

    With the other roof, insist on a re-inspect with your contractor there to point out the damage from hail. In this case, the squeaky wheel gets the grease. However, if you didn’t have hail damage there, then the policy will not pay for a roof that just needs replacing and wasn’t damaged by hail

  721. September 18th, 2011 at 2:39 am #Tracy

    Hi,
    I hope I’m doing this correctly. I can’t find a place to post a question only submit a comment? Sorry if I interrupting conversations.

    We decided to rent our house. We had an insurance adjuster come out and value the home. After a few months of repairs and upgrades we called 3 times, over the course of a couple years, and asked them to come out and revalue the home. They did not do this and subsequently the house has burned down. We were insured for 188,000 and the insurance company has agreed to pay that amount. They also estimated it will cost 220,000 to rebuild. The insurance adjuster said it was our responsibility to to increase the value of the home. What do you think? Since the home was undervalued and no one would come out to revalue do we have any chance of receiving more funds for a rebuild.

  722. September 18th, 2011 at 8:52 am #vernida

    My question is why does it take so many step and interviews and repeat form filling out to resolve my claim after a burglary. My premiums were paid timing w/o hesitation and now it is if I am the bad person here – loss occurred June 2011 and still today having now to fill out yet another confusing form called sworn statement of loss which in title makes sense however form itself is mind boggling so would someone out there with any claim knowledge help me out with these two questtions – thank you

  723. September 18th, 2011 at 7:04 pm #Eric

    My sister has just gone through a divorce and her ex husband pretty much gutted the inside of the house while they were separated. Now she has the house and can’t afford to fix it. Is this something insurance will cover?

  724. September 18th, 2011 at 9:59 pm #Jason

    Tracy,
    No, the insurance company doesn’t make sure you insure the home to the correct amount – that is your responsibility. You are the home owner and you have the direct stake in the home so that falls into your area of responsibility. Take the insurance proceeds and do what you can with it. There is no way you are going to get anymore than that.

  725. September 18th, 2011 at 10:02 pm #Jason

    Vernida,
    I would be happy to help you with the questions you have and the statement of loss and/or the Sworn statement in proof of loss that you have. What questions do you have?

  726. September 18th, 2011 at 10:03 pm #Jason

    Eric,
    It’s very, very unlikely the situation you described would be covered by insurance.

  727. September 19th, 2011 at 12:44 pm #John

    Concerning mitigation costs. Are mitigations hours that I put in to stop furthur damage claimable such as further water intrusion and mold damage, or does it have to be through a contractor?

  728. September 19th, 2011 at 12:58 pm #Nicole

    I talked with my agent’s team member at Liberty Mutual who stated that my policy would cover a busted pipe which has caused water damage in my air duct system and my house to smell like sewer. The claims adjuster states that my claim will be denied based on the fact that it doesn’t cover water damage to the foundation, slab or heating and cooling system. I’m so confused right now that my head is spinning. I keep getting different answers from agents and claims adjusters, even supervisors. I just want my pipe fixed and my house to not smell like sewage. What can I do?

  729. September 19th, 2011 at 2:37 pm #Karmen

    Insured w/ State Farm and am finally getting to end of a claim dispute after 2 very long years. I acted as our own General Contractor. Am I entitled to the GC overhead and profit?

  730. September 19th, 2011 at 4:51 pm #vernida

    Hi Jason

    wow you much quicker than my insurance Co but thank you they finally did respond its just been a frustrating ordeal since it began 3mos ago – paper work after paper work

  731. September 19th, 2011 at 7:44 pm #Jason

    John,
    Present your efforts, hours, and what you did to the insurance company/adjuster. Sometimes contractors are not available to do protective work. It’s reasonable that your efforts should be reimbursed or allowed to be paid by the policy.

  732. September 19th, 2011 at 7:52 pm #Jason

    Nicole,
    While your insurance company tries to figure out if it’s covered or not, why don’t you get the issue fixed? Regardless what the insurance company does, that is what you have to do. You can’t let your life revolve around the insurance company that gives you conflicting information.

  733. September 19th, 2011 at 7:56 pm #Jason

    Karmen,
    That’s a very good question. Some insurance companies will allow that and some won’t no matter what. Then there are some that allow overhead but won’t allow profit. All you can do is present the overhead and profit, while demonstrating that you did act as the general, and hope state farm pays this reasonable charge when a general really does orchestrate and coordinate the activities of all the sub-contractors.

  734. September 21st, 2011 at 6:54 pm #Holly

    We came home on Thursday from a week vacation to find a water leak in the attic. Immediately called insurance agent and plumber to fix the leak… Adjuster came out next day. We had approximately 2″ water in home and caved in ceilings in 3 rooms, plus the kitchen has to be torn out. Water restoration started and here comes the problem, the Adjuster told us that we had to live in the home even though the restoration company was wearing masks in our home. I should mention here that I have a 2 year old and 4 year old. Needless to say, the Adjuster came out today (Wednesday) and an argument started between my husband and the Adjuster in which he told us our kids weren’t his problem and he didn’t care if there was mold in our house or not. About an hour later I spoke with the Adjuster who told me he would no longer be handling our claim and a new Adjuster would be out in a few days. Does this mean that the whole process has to start over? Is there anything I can do speed the process along? We just want to be back in our home. Any advice is appreciated. Thanks.

  735. September 21st, 2011 at 8:30 pm #Jason

    Holly,
    If your home is not habitable, then your insurance company should provide you with additional housing expenses to set up a temporary residence while the repairs are being completed. If it affects only a small part of your home and you can live in it as the first adjuster seemed to think then that would be reasonable to do. We don’t know your home’s current condition just by what you posted so we don’t know if you can reasonably remain there or not.

    An important thing to do is to work with your adjuster and they will work with you. Keep your requests reasonable and don’t argue with them. Arguments just slow down the process and nobody wins in that type of situation. The adjuster didn’t cause the leak. It happens and everybody has to deal with it.

    Now, will the entire process have to start over? Not entirely but when you bring in a new adjuster, they have to pick up where the last adjuster left off and it might seem as though they are starting all over again.

    Personally, I would think if the kitchen is affected, then it would be reasonable to put you up in temporary housing while the repairs are being done. I indicate that because a kitchen is a commonly used part of the home many times during the day.

  736. September 25th, 2011 at 3:42 pm #Norris

    I pissed off my brother so he decided to destroy my drum set. As far as I know it is totally useless and most parts are broken. Since this is vicious vandalism using major violence, can this possible be covered under homeowners insurance? And he lives with us. He is 31 and as far as I know my parents did not claim him on taxes as a dependent.
    Thanks

  737. September 25th, 2011 at 6:36 pm #Jason

    Norris,
    Since you are living with your folks you are insured under their insurance for damage that occurs to your property. Unfortunately, your brother also lives in the same household and he is also an insured under your folks insurance policy. The limitation there is that the policy has a restriction in it that damage caused by an insured is excluded.

    If your brother is 31 and living with his folks, he needs to get a job and move out. He may also need some anger management classes.

  738. September 25th, 2011 at 8:09 pm #John

    Hi Jason, Great site with tons of useful information. I just went through the entire site and couldn’t find anything close to my question, so here goes.

    First some background: On July 26, 2011 we lost our home and outbuildings to the largest wildfire in New Mexico history. State Farm was quick to cover additional living expenses and as of this writing they have paid the policy limits on the dwelling, dwelling extensions, debris removal and even compensated for trees and landscaping. We are now in the process of dealing with the personal property and so far I expect that process to go well and “hit” our policy limits there too.

    Here comes the question: I recently received a call from a Public Insurance Adjuster that is very interested in talking to myself and my other neighbors who lost everything about what he can do to help. I said that I felt that my relationship with State Farm was going well and that we in fact so far we had received our policy limits. At that point I was surprised to hear him say that he could get us “more” than my policy limits. I feel that the policy limits are fair, but have agreed to meet with him to just talk next week. My neighbors are excited but I am very nervous. Could he really get us more than our policy limits and will that ruin our relationship with State Farm? Thanks in advance.

    John

  739. September 26th, 2011 at 6:33 am #Norris

    As of now he has had a restraining order for imminent threat of bodily harm put on him. He is also using drugs and alcohol and we had just tried to get him to stop abusing substances. Will this make any difference?

  740. September 26th, 2011 at 8:02 am #Kathy

    I filed an insurance claim for a gagage fire on setp 6th 2011. How long does it take to settle the claim and receive the insurance money? The adjuster has been out and the report has been filed.

  741. September 26th, 2011 at 7:25 pm #Jason

    John,
    I’m not particularly favorable of public adjusters but yeah, they may be able to get you more than your policy limits. Be careful to understand their fees to you. For example, their fees may be 30% and that might include the parts of your claim that are already settled. I don’t know each specific contact out there involving public adjusters so this may not apply at all.

    People who have things going well between themselves and the insurance company probably doesn’t need one to assist. There are times when public adjusters do a great job and that is helping an insured get their claim money when the insurance company is not being fair to the insured because of the insured’s lack or insurance knowledge.

  742. September 26th, 2011 at 7:31 pm #Jason

    Kathy,
    You can probably expect it to take up to a month. Hopefully it will be sooner but that is the deadline many insurance companies attempt to meet at the latest. If settlement happens sooner, than that is good for everybody. Those are run of the mill and uncomplicated claims. Claims that involve many other people such as various experts, arsonists, lawyers, public adjusters, etc. will take longer.

  743. September 26th, 2011 at 7:35 pm #Jason

    Norris,
    No those things won’t make a difference. The only things that will make a difference is if he is both a vegetarian and someone with frequent heartburn.

    I didn’t mention that before because, as we all know, vegetarians rarely, if ever have heartburn. So, that would be a long-shot to have frequent heartburn if you are a vegetarian.

  744. September 27th, 2011 at 7:53 am #Norris

    What exactly does being a vegetarian with heartburn have to do with it? Although he does have horrible heartburn. If you mean it’s because of the drugs we know for a fact he is on drugs and mentally ill.

  745. September 27th, 2011 at 8:14 am #Jason

    Norris,
    That is basically the question I was asking you – what does him being on drugs and alcohol have to do with whether or not coverage would apply for your drum set?

  746. September 27th, 2011 at 6:54 pm #Norris

    I was hoping there might be a clause or something that would apply to mentally ill people or someone on drugs.

  747. September 29th, 2011 at 12:38 pm #Cynthia

    I am looking for help. I had a pipe block and water from the softeners backed up through the kitchen sink and in to the kitchen cupboards and floors. There was severe water damage done to the kitchen and to the basement. This happened on September 5th.

    The restoration crew cleaned up the mess and removed the kitchen floor and half on my kitchen cupboards.

    I am now in my fourth week of walking on a cardboard kitchen floor with my three children and it is getting to me. The adjuster has just asked for another estimate to have the kitchen refaced now and not replaced….Firstly, she wasn’t happy with the software that is used by State Farm, now she is not happy with the two estimates to have the kitchen replaced and now she is talking about getting it refaced.

    What are my rights….I had the crew scheduled next week to start getting my house back in order. My house is very unhygienic with a kitchen out of cardboard and people wearing shoes because there are nails that pop out underneath the card board….what can I do???????

  748. September 29th, 2011 at 6:22 pm #Jason

    Cynthia,
    With the nails that are popping through the cardboard, you can take a hammer and pound them in so they won’t stick up through the cardboard.

    Get a claim supervisor involved and tell them your situation and what you want done. If you have to get the cabinets refaced, get an estimate as soon as you can. If that is what the insurance company is requesting of you, you should supply that through a contractor you’ve chosen so you can get your kitchen back to order.

    What is really odd is that state farm should be able to write your estimate for the work that is needed and then cut you a check for the estimate of damage.

  749. October 2nd, 2011 at 5:04 am #Donald MacIntyre

    Hi

    We had saturation to a bedroom wall so took up the floor and found a leak in a heating pipe. We called a plumber who came and repaired the pipe and we then called our insurance company who sent out a loss adjuster. The loss adjuster sent out a plumbing specialist who met with the plumber over two days to inspect our plumbing. They both said there was no more leaks. The loss adjuster then sent out an engineer who established that the entire ground floor was saturated and to wait to hear back from the loss adjuster. We contacted our own engineer and loss adjuster who said everything on the ground floor should be removed to facilitate drying out the concrete sub floor. The insurance company did not beleive this and over a year sent out various engineers to back up their claim and when none of them would they backed down and said everything should be removed. Over this time the house became progressifly worse. The floors upstairs buckled as well as doors and the stairs and mould is growing throughout the ground floor. This involved more engineers who all said the moisture from the ground floor could not have caused this. We have now been in a legal battle for three years and just recently the tarmac at the rear of the house has given way and potholed in many areas. I contacted our engineer who informed me that there must be another leak, he told me to turn of the water supply and to check the water tank levels to see if any drop. After 2.5 hours the two 60 gallon tanks had droped by half indicateing that we are loosing 24 gallons per hour if you add that up over the past few years it amounts to over a million gallons of water. Could you tell me who is responsable

  750. October 2nd, 2011 at 6:19 am #Jason

    Donald MacIntyre,
    Responsible for ..? It appears your question is not complete. Responsible for your home, the piping, the delay, water consumption, checking pipes, fixing damage?

    Also, your assumption with the water loss is not necessary correct because there is no indication that the water has been leaking at the same rate during the entire time it was leaking.

    Also, I may be mis-understanding your loss rate over the past few years but roughly using the information you provided, and assuming a constant loss rate of 24 gallons an hour, that amounts to roughly 210,000 gallons a year. That would mean in 3 years, that would be around 630,000 gallons and not over 1 million gallons.

  751. October 2nd, 2011 at 8:07 pm #Ann

    Allstate recently phoned us back after we claimed for hail damage to house and vehicles…they claim that the roofing company is over-charging and that they are not willing to pay for the estimate submitted by the roofer….this roofer was used by the whole neighborhood and we waited 4 months for him to finish other claims first….everybody around us is happy with his work, quality and costs…on what basis can Allstate make such a claim against a reputable company? Is this ethical? I told them to sort it out with roofer since I am not an expert and cannot belief they can make such an accusation to me without proof or some substantial evidence.

    Allstate short paid us on the vehicles – we had to remind them that the checks issues were for incorrect amounts – three different adjusters had to visit the vehicles before it was written off after the 1st adjuster totally underestimated the damage and costs of the repair….complaints to Allstate resulted in an excuse of they had to hire a lot of inexperienced people due to the widespread damage of the April storms….seems to me that they are constantly trying to cheat us out of money. They also short paid on several outside items – which we fought for and got quotes of the actual items we purchased.

    Any info regarding the legality of how they are approaching this is appreciated

  752. October 2nd, 2011 at 9:47 pm #Wati

    Hi,

    My question is ” are policy holders restricted after settlement on what you can and can not do with settlement money.

    E.g If I want put up an extra room or a deck which was not there when fire happened.

    Thanks

  753. October 5th, 2011 at 4:02 am #LQ

    Hi I posted a question last night and now I dont see it. Did you get it? Should I repost?

  754. October 5th, 2011 at 4:40 pm #admin

    Dear website visitors,

    Most of our questions and answers for October 3rd and 4th were lost as a result of a malware attack on our website. In addition, some of our pages were “redirected” to malware websites. We have now incorporated stronger security measures.

    While we have no proof as to the original source of the hackers, suffice to say that this website had never experienced hacking problems until shortly after we posted the page “BOYCOTT FARMERS INSURANCE?” which exposed criminal acts by Farmer’s CEO and their Los Angeles based attorney Richard O Knapp.

  755. October 5th, 2011 at 8:36 pm #aNYmouSE

    HA – Imagine that! A corporate giant committing criminal acts and then behaving as cowardly street thugs!!
    No you have no proof, however you really need none. Of course that is what happened. Not to make light of your site being hacked, the criminal acts of these companies not only devastate individuals, they have a major impact upon our entire economy.
    Let’s see – there is currently a march/protest on Wall Street which has spread to protests in other cities across America, because of the crimes committed by Wall Street, which no one has been held accountable for. I have joined the protest in my city. Tomorrow I will suggest to my group that the protest be extended to include insurance companies, banks and of course our ‘representatives’ in Washington. These types of cowardly acts only happen because they can.
    To anyone paying attention; until an insurance company has ruined your life, (which happens to individuals every day) you will never understand (or perhaps even believe) not only the immense greed that drives their criminal behavior, but also EVERY claimant is a potential victim.

  756. October 8th, 2011 at 2:20 pm #Jimmy Link

    First off.. I have replacement cost Homeowners Insurance with State Farm on my primary home. I’ve been insured with them for over 20 years with only one claim which was less than $700.. I also own an unoccupied house about 15 miles away that I have no insurance on due to it being unoccupied. I mainly used that house to store some of my belongings. This past week someone broke in the unoccupied house and stole almost everything that was stored there even down to the stove and refridgerator. Should my Primary Home’s homeowner’s insurance cover any of my loss?

  757. October 8th, 2011 at 7:31 pm #Jason

    Jimmy,
    The duration of time being insured with a company has no affect on claims.

    Personal property is covered anywhere in the world so you should have coverage for what was stolen. There are some limitations to that coverage and that may be to items that are stored, not used, and obsolete, etc. The only way you will know for sure is to make a claim. Applying the limitation of stored, not used, etc. is rather broad and difficult to apply to anything because most things we own are stored or not used for long periods of time.

  758. October 9th, 2011 at 5:38 pm #Earl

    I am at my wit’s end! I had storm damage to my roof back in April of this year and got a good reference from a friend about a roofer to inspect and give an estimate on repair/replacement. The roofer suggested that I file a claim and even offered to help me with the process. I have never (in the 20 years I have been out of my parent’s home) had to file an insurance claim of any kind, so I took them up on the offer. They were very helpful and even met the adjuster when he did his inspection. I received the initial check from the insurance company and (because of the reference from a trusted friend and my obvious trusting nature) I gave it to the contractor . . . you can guess what happened. I saw them on the news a week later, they were being investigated for insurance fraud. They have cashed the check, not done any work, and the owner has lost his license and gone to jail. He is out now, and the Sheriff’s department told me he was told by the judge to make restitution for all of the hundreds of people he defrauded, but I shouldn’t get my hopes up. I called my Insurance Co. (Allstate) and they told me there is nothing they can do. Is this true? I explained that I cannot afford to have the work done on my own and the roofer is obviously not going to do it or give me a refund, but there is still the damage to my roof that gets worse each time it rains! What recourse do I have to get Allstate to fix the roof? Any? Thanks, I know this is a long question, and I was naive . . .

  759. October 9th, 2011 at 9:47 pm #Jason

    Earl,
    You’ve had your recourse with your insurance company and they did what they promised they would do. Their obligation to you is over. You’ll just have to get the repairs done by some other means.

  760. October 10th, 2011 at 4:45 pm #Kristie

    We received water damage from a bad storm water pentrating the stucco from cracks. This damaged our living room carpet also we had water damage in our bedroom which has laminate flooring. Does the insurance company ( state farm) have to pay to replace all the floors so they will match? Can we request for them to replace the carpet in the living room instead of cleaning it. Water extraction was out today to dry out.

    Adjuster will be out tommorow. Any Help would be appreciated we have never filed an Homeowners insurance claim.

  761. October 10th, 2011 at 8:57 pm #Jason

    Kristie,
    The policy is for direct damage to property and matching isn’t damage. So, they don’t necessarily have to match. They just have to allow for the direct damaged items to be repaired or replaced.

    You situation raises more concern than just matching. Water coming through walls or building materials absent damage from a storm may no trigger coverage for the interior water damage.

    Of course you can request replacement instead of drying. However, they don’t have to honor your request. And the main thing is if this is a covered loss that you policy provides coverage for.

  762. October 10th, 2011 at 9:23 pm #Jason

    *may not trigger coverage

  763. October 11th, 2011 at 11:08 am #Kent Campbell

    We recently had a battery leak in a portable stereo that permanently damaged a $5,000 counter top. Our Traveler’s homeowner insurance is denying coverage based on an exclusion for “seepage of any pollutants or acid”. This does sound pretty specific, but just in case, do we have any kind of recourse or alternative with the insurance company?

  764. October 11th, 2011 at 11:21 am #Jason

    Kent,
    The language of your policy is likely written much like this:

    2. We will not pay for loss or damage caused by or resulting from any of the following:

    1. Discharge, dispersal, seepage, migration, release or escape of “pollutants” unless the discharge, dispersal, seepage, migration, release or escape is itself caused by any of the “specified causes of loss.” But if the discharge, dispersal, seepage, migration, release or escape of “pollutants” results in a “specified cause of loss”, we will pay for the loss or damage caused by that “specified cause of loss”.

    It appears the denial of this loss is appropriate and I don’t envision anything happening other than a denial.

  765. October 11th, 2011 at 11:43 am #admin

    Kent, consider a 3rd party claim against the radio or battery mfg. if there was negligence on their part?

  766. October 11th, 2011 at 11:53 am #Kent Campbell

    That’s kind of what we figured. Maybe time for a new insurance company.

  767. October 12th, 2011 at 8:28 am #Jason

    Kent,
    That exclusion exists in every single policy that is out there. Switching to another insurance company won’t remedy that. However, you should be reviewing your coverage and insurance costs about every 3 years. Most insurance coverage is pretty much the same but premium costs can vary substantially.

  768. October 12th, 2011 at 4:09 pm #Melissa

    Hi.
    I had a house fire back in Feb 2011. At the time I did not live there and had a renter. The house caught on fire and destroyed most of the house. The insurance company Michigan farm bureau came out and the adjuster was nice at first. She said that I could rebuild it and the back two bedrooms would be saved and the house would be taken down to the studs and then rebuilt. I told her( adjuster) I didn’t want to rebuild it since I didn’t live there and didn’t want to deal with another renter. I just wanted to get any money owed to me and pay off the mortgage and clear out the property. The adjuster stated that she didn’t think I could do that. After calling her several times with no answer I was getting mad about the situation. Two months or so went by and I had gotten a letter in the mail from a public adjuster. I called them and decided to let them deal with the insurance company which was a good thing for me since my insurance adjuster never told me that I had sixty days to get in my proof of loss and by the time I contacted the PA I had only 14 days to get it in. So, I got that in and it has been a waiting game ever since. The insurance company is supposed to be giving me a rent check to cover the lost rent they gave me three checks so far and have stopped giving me the rent check. I called the PA and they told me to deal with my insurance adjuster myself when dealing with the rent check. I have called and called sent emails and no response from farm bureau. Farm Bureau sent me one check for the actual cash value of the property and I haven’t cashed it because the PA told me to wait. That check won’t even be enough to pay off my mortgage. My house was insured for 95,000. the check is for 31,000 and my mortgage is 49,000. On the 31,000 check it states that it is for actual cash value of the property and that I had 120 days to ask for replacement value and I am assuming this means to replace the house since I didn’t have any contents in there only the stove, refrigerator and the dishwasher. I am wondering it has been eight months and I am still waiting to get money from farm bureau. They were supposed to do an appraisal back in June 20011 and the PA says they are still waiting for numbers to come back from that. well it has been four months since the appraisal and it seems like farm bureau just wants to drag their feet. I’m getting really mad because I have to pay a house payment on a house that I don’t even live in and I am working full time going to school and raising three kids and it’s a struggle to pay that extra house payment. How long does this whole process take??? What should I do just stop paying the house payment? I called a lawyer and they said just wait and see what the PA can do and to me it seems like it’s taking forever and farm bureau is stalling with them too. How much longer?? I can’t wait forever! HELP!! oh and Michigan Farm Bureau…..U SUCK!!!

  769. October 12th, 2011 at 5:46 pm #Jason

    Melissa,
    I don’t believe Michigan is a stated value state. If it was a stated value state, then they would pay you the policy limit for the property in the event of it being totaled. Now the check they sent you is for the actual cash value to repair the damaged portion of the home.

    Within 180 days from the date of loss, you need to have the repairs completed and then submit a claim for the amount that it cost over what they initially paid you up to the policy limit (or the replacement cost estimate amount).

    I don’t know what the public adjuster is doing for you but they probably are content collecting their percentage of the agreement they have with you in regard to your settlement amount.

    Because of the time that has passed, what has and what hasn’t occurred, and all the rest of what you indicated, this claim is basically settled with the checks that you have already received and there is probably nothing else that is going to happen.

  770. October 12th, 2011 at 6:35 pm #Scott

    Hi,
    I live in Pennsylvania. My insurance company sent me a check to replace my hail damaged shingle roof after taking a contractor of their chioce to inspect and estimate the damage. The check was for about %70 percent of the total and the balance would be paid upon completion of the repairs. I performed the work myself and notified the adjuster. The adjuster said that in PA the law is written that you cannot profit from an insurance loss and that all the figures need to be adjusted lower. I wished they would have made that clear upfront. Someone told me that the PA law does not allow the insurance company to withold a portion of the claims check until the repairs are completed. Also, the contactor that the insurance company brought to estimate the damage sent me a bunch of papers to sign which appeared to be intentionally confusing contract documents. I can see where alot of older people may have signed the papers not knowing they were locking themselves in to one contractor. I am not sure sure where to get advice. Can anyone give me some insights or direction?

  771. October 12th, 2011 at 6:45 pm #Jason

    Scott,
    I fail to see how you would profit from replacing the roof yourself. When roofers remove and replace a roof, they get paid for their labor. Just like you should. The roofer gets paid for labor and materials just like you should get paid for the materials you purchased and the labor you expended to remove and replace the roof.

    If they are saying you can’t profit, they are literally taking away the reimbursement for your labor. Is that profiting? No, it’s you doing your own work and knowing how to do it properly. There is no law anywhere that indicates that a homeowner cannot make their own repairs (well there are some limitations) but you should be able to do your repairs and be paid the full cost of doing that. It’s called payment for labor and materials. You should be paid the same rate as a roofer if you do all the same functions as a roofer.

    This insurance is getting too carried away because you are not profiting. The work is now done and you need to be paid for the material costs and reimbursed for your labor. Good luck. I back your efforts.

  772. October 14th, 2011 at 6:02 pm #Justme222

    I have a claim for my home by way of fire. The home is pretty much damaged and the insurance adjuster wants to make sure I could prove that I could afford the remodeling that was done to the house. Can she deny my claim if that can’t be proven? Also, I have alot of contents in the home that was from a previous business that was shut down at least 3yrs. ago. Are those contents considered personal property now or still business? Is my insurance company required to pay for those contents too?

  773. October 14th, 2011 at 6:56 pm #Jason

    Justme,
    I don’t know if that is the reason for their requested information. We don’t know enough about your claim to provide you with any information. They are probably doing a financial review of you and that may be a little bit more complicated than asking a question on here and receiving an answer.

    Your financial situation, a prior business, and a fire claim may require a lot of investigation before a coverage determination can be made.

    Again, we don’t know enough about the property you referenced to provide an answer.

    Also, we don’t know the origin or cause of the fire and that still may in the discovery stage. Not to cause alarm but you may want to discuss your claim with an attorney.

  774. October 14th, 2011 at 7:13 pm #Justme222

    Jason,

    Based on what the insurance adjuster told me, that is the reason. She was actually up front about that. The question is: can a claim be legally, or rightfully denied based on finances if you can visibly see the contents even after the fire. Question 2 is: If a business is shut down does the inventory become personal property if it’s in your home?

  775. October 14th, 2011 at 7:42 pm #Jason

    Justme,
    Those are not simple yes or no questions. We don’t know enough about your claim and if we provide information based on not knowing enough about your claim, it is very likely we may provide wrong information and that will not benefit you. That applies to both of your questions.

    We don’t know if the business was a individually owned, a corporation, a partnership, or a non-profit. We don’t know anything. And even if we knew some of the limited information about your situation, we still would not have enough information to provide you with an accurate answer. The information we would need to answer those questions would be the type of information only a qualified attorney could address. The questions you pose are very complicated. We cannot carelessly provide information on this site no matter how much we want to help.

    In a way, the questions you pose are legal questions.

  776. October 14th, 2011 at 7:49 pm #Jason

    Justme,
    If you want to review a different claim question posed that involves a business, look under category of “Denied Insurance Claims – post # 216, 218, and 227. The answers provided to those questions were vague as well because we don’t know enough about the claim or the situation. We aren’t able to get involved to the extent required to answer all the questions submitted.

  777. October 14th, 2011 at 8:25 pm #just me222

    Jason,

    Thanks for your honesty. I knew it was a difficult question, but I was trying to avoid the costs of a lawyer. Sometimes we just gotta give in and you helped me with that.

  778. October 16th, 2011 at 1:41 pm #justme222

    Jason,

    Exactly what type of lawyer should I contact to help me with my claim?

  779. October 16th, 2011 at 1:47 pm #Jason

    Justme,
    One that handles contract law. Most will be able to assist you but chose wisely. Lawyers are expensive. Use the benefit of a free consult with these attorneys if they offer you that so you can review them before you commit to one.

  780. October 16th, 2011 at 1:49 pm #Jason

    Justme,
    One that handles contract law or insurance law (which is basically the same thing). Almost any attorney will be able to assist you but choose wisely. Lawyers are expensive. Use the benefit of a free consult with these attorneys if they offer you that so you can review them before you commit to one.

  781. October 18th, 2011 at 11:05 am #David

    We have liability claim against a A/C contractor that caused a severe water leak that damaged our hardwood floor. The home is a single floor house with a continuous hardwood floor throughout. The contractor’s insurance company refuses to cover replacing the floors for any rooms that can be blocked from line of sight by closing their doors. Even a room that has double french doors which are meant to be open has been refused. The company says this is an industry standard, but I’ve been told that standard applies to carpet and not hard surface floors. They have offered a settlement price. Should I hire an attorney? If i keep pursuing this, can they retract or lower their settlement offer?

    David

  782. October 18th, 2011 at 11:42 am #Gina

    Ours is a long story but will keep this in brief. November 8, 2010 we lost our home and entire contents to a fire. Insurance check was issued (after a bit of a fight) and signed over to mortgage company so we could set up our draw account when we started construction of the new home. Finally in late July this year the 1st draw was collected and 1st phase of work done. 2nd phase involves a modular home (which was most affordable with the insurance money received) and home is set on foundation. Now the mortgage company is not releasing the funds saying the investor doesn’t approve the structure change. Could I get the insurance company involved regarding this money? I am using the Atty Gen office, OCC, BBB and many other organizations to get Bank of America to release the funds. Just wasn’t sure if involving the insurance company would help… Thanks 🙂

  783. October 18th, 2011 at 8:56 pm #Jason

    David,
    You have a couple of choices. Settle this claim with this contractor’s insurance company or turn the claim into your insurance company, pay your deductible, and get the damage fixed.

    Your insurance company likely has a contract with you to address damage based on replacement cost.

    Any liability that arises because of negligence, all that insurance company is obligated to pay is ACV.

    Why do you want to get undamaged flooring repaired? If the contractor didn’t damage it, then he and his insurance company is not responsible for items they didn’t damage.

    You can pay an attorney if you want. That is your option. Besides your options to get this resolved by either insurance company, why would you want to pay the hourly fees of an attorney?

    Just like you have the option of not accepting their offer, of course this insurance company can reduce or withdraw their offer.

  784. October 18th, 2011 at 9:07 pm #Jason

    Gina,
    If your lender doesn’t want to finance a home you are constructing, then that is a borrower/lender issue. It has nothing to do with insurance.

  785. October 19th, 2011 at 3:42 am #Gina

    Jason –
    It does have everything to do with insurance. We were given the settlement check for our home loss. Turned it over to our mortgager to “hold” while we forego construction. They approved the draw schedule, disbursed the first draw and now are dragging on the 2nd draw. We have an insurance check from the loss and its not being returned. I was asking, although I know its our mortgage company holding the money, that if it would be wise to involve the insurance company since they gave us the money for loss and obviously also want to see the home rebuilt.

  786. October 20th, 2011 at 3:31 am #Jen

    Jason,
    A few weeks ago, my house burned resulting in what appears to be a total loss. Is one tactic of the adjusters to just leave you hanging in limbo? They (Frankenmuth) put me up at a motel now. I stayed at a friends for 9 days. I gave them slightly more than the 25.00 per night recommended by the adjuster. I’ve received minimal info about what to expect as far as time-lines, or sequence of events. I’ve been in process of moving to Florida, but I don’t dare leave till this is settled. I had replacement cost on contents and structure. I live in a small depressed community with many houses on the market. They advanced me 2500. on contents about 10 days after the fire. I had essentially no furniture here with quite limited personal effects. Mainly tools, clothes, computer and home repair items. My move has been 2 years in the making. This 100 year 2-family had my undivided attention over the past 4 months. I also had some assistance. I had just listed the house on Friday, though it wouldn’t hit the MLS till the following week. Monday night the neighbor called. Need I continue?
    The insurance and fire inspectors found where arcing had occurred. I’m presuming that caused the fire. After about a week the contents people came out and did an inventory. I just mailed that back after reviewing. Do I understand I’m not locked in to that being a final accounting of items? I know there are more, but I (at least) am trying to expedite, or not further slow the process. Listing price was 37,500.The adjuster made comments like that minus 6% commission gives us the value we’re dealing with. I said nothing. Some people came to submit a bid for site clean-up / debris removal. They measured structure, rooms, windows and doors. Maybe for hopeful rebuild, or maybe a half-a….reconstruction estimate? It is a 1700 sq ft structure. Finally, my concern is in determining acv. The real estate market here is poor to crappy. There aren’t good 2 unit comps in this price range. The policy limits are 144,000 plus an additional 25%. I did mention my intent to move South and not rebuild here. Of course, nothing was offered to me about building offsite, or even buying a replacement in Florida. Imagine that! So, how will acv be calculated and should that check be expected in the near future? Frankenmuth mailed me a copy of my policy within a week! But, when I went to the agency and tried to get a copy I could only get a dec sheet of my coverages. When I tried to explain I wanted the policy that delineates how those are applied, or the rules, the agent smiled and said he didn’t know what I was talking about!
    And I thought I had blonde roots. I’m just getting into your book now. The longer this takes the more educated I am becoming with policy in hand . Thanks in advance for all your help.Jen

    Having recently purchased your book, I’m slightly more hopeful of handling my claim without a public adjuster. This

  787. October 20th, 2011 at 3:33 am #Jen

    Forgot to mention, I’m in Michigan. Jen

  788. October 20th, 2011 at 8:55 am #David's Wife

    Hi Jason,

    Thanks for taking the time to respond. I just wanted to clarify an issue. Our hardwood flooring is unique, and according to both our own hardwood contractor and the insurance company’s adjuster, it cannot be matched. That’s why they have to replace all the floors (even the areas that are not damaged). The problem is that they won’t replace bedrooms or the study, both of which have the continuous hardwoods. So, what we’ll end up with is two different hardwoods butting up against each other at the bedroom doorways and study entrance. Hope that makes sense.

    We have not wanted to go with our own insurance company b/c of our $$ deductible and possibility of increased premiums (plus the fact that the air conditioner co’s insurance has already accepted liability). We’re considering an attorney to force the other insurance company to include the bedrooms and study. It doesn’t make sense that they would repair 2,000 sq feet of hardwoods because they can’t match the very small area that is actually damaged, but then exclude other rooms.

    Thanks again.

  789. October 20th, 2011 at 10:58 am #Deb

    Nationwide recently denied a claim on our homeowner’s policy due to “earth movement”. This earth movement has claimed our home. We had to abandon it because it is structurally unsound. We thought originally we had a sinkhole and a sinkhole and any damage caused to the structure by a sinkhole was covered under our policy. They originally wanted to deny our claim without even sending out an adjustor, but we insisted on an assessment. They sent out a forensic engineer who declared that it was not a sinkhole that the damage was due to “earth movement/slope failure” and since our land is excluded under our policy any damage resulting from the movement of the land is excluded. They estimated repairs in the amount of $250,000. We had preliminary work done while waiting on their report in the amount of $25,000, trying to save the structure. After receiving the denial, we determined we could not afford to make the repairs on our own and are now in foreclosure with the lenders. They are attempting to shortsale the real estate, but the house will need to be demolished. I just can’t believe that Nationwide cannot be responsible for this situation. They have abandonded their obligation to us and the lenders. Do we have any recourse?

  790. October 20th, 2011 at 2:31 pm #JM

    We have a a home in one state that has current homeowners insurance on it including an additional rider that covers jewelry (and some other types of items.) It is our understanding that this cover loss and theft regardless of where the loss/theft happened. Here is where it gets tricky… we recently moved (still own first house and insurance policy) and now own an additional house in another state that is also insured but because we were rushed in getting the policy in place before closing, the insurance salesperson said we should just get the basics and add additional coverage later. We have not yet had an opportunity to add the additional coverage and a day and a half ago my bag containing my engagement ring was lost/ stolen. We have filed a police report and hope (for obvious sentimental reasons) that the ring is recovered but are thinking that we should go ahead and file a claim. My question is this: Are we in danger of having the claim denied because we are not currently residing in the house with the rider full-time?

    A little additional info: I have done done anything here to establish myself as a resident such as get a driver’s license, library card, car tags or job. Also, I am not not listed on the mortgage here but am on the deed because this is a common property state.

    The two houses have homeowner’s policies with different companies; Travelers for the first house (with the additional coverage) and Allstate for the second house.

    Thanks so much for any advice!

  791. October 20th, 2011 at 4:57 pm #Jason

    JM,
    You have insurance for loss/theft of your ring. There may be some coverage limits for jewelry unless you have the ring specifically insured to a certain limit. With the information you provided, your claim appears to be covered and there is no reason it should be denied.

    There may be a need to make a claim with both your insurance companies but that may not be required unless they ask if you have any other insurance. I

  792. October 20th, 2011 at 4:59 pm #Jason

    Deb,
    No.

  793. October 20th, 2011 at 5:30 pm #Jason

    David’s wife,
    I understand the situation. I’m under the impression that wood is a natural item, and there is variance in every wood species. That is what makes wood unique because there is so much randomness to it and no 2 pieces will ever match each other.

    So, since 2 pieces in your current floor already do not, never did, and will never match anything you put next to it, the issue of matching will never be solved. That is because wood is not able to be matched.

    So, if you are trying to match something that cannot be matched, I hold the position that direct damage should be addressed and leave the undamaged items alone.

    You can hire an attorney if you want. Attorneys can’t force anybody to do anything. If you wanted to force them to do a certain thing, you would have to sue them and secure a judgment. When you have that judgement, you would have to enforce the judgment to get the other party to complete the requirements of the judgment.

  794. October 20th, 2011 at 5:51 pm #Jason

    Gina,
    The money may be from insurance but the bank is holding the money, not the insurance company. This has nothing to do with your insurance company (other than where the money came from).

  795. October 20th, 2011 at 6:13 pm #Jen

    Hi Jason,

    I emailed you earlier this a.m. #786. Is this where I should hope to find a response? Thanks, Jen

  796. October 20th, 2011 at 6:50 pm #Jason

    Jen,
    I didn’t really notice if a response was needed to your post. I don’t know when you should expect a settlement. They will determine ACV by what your place is expected so sell for at this time or based on the cost of replacing the damaged parts of the home after applying depreciation to those items.

  797. October 21st, 2011 at 7:17 am #Deb

    Is that really all I get is a no? What do other people do in this situation? We’ve lost everything through no fault of our own. We couldn’t have predicted it or prevented it. Is there some other organization out there that helps in these situations? How are we suppose to recover?

  798. October 21st, 2011 at 7:37 am #Jason

    Deb,
    There is no need to be at fault in order to lose everything. Sometimes that happens. Somethings are neither predictable nor preventable. However, in your case, your insurance did not want to cover earth movement so it excluded it from coverage. In a way, they prevented their liability from that type of event.

    Sometimes there is no recovery. This loss is not transferable so it remains with you. Habitat for Humanity, Red Cross, Salvation Army, etc.

  799. October 22nd, 2011 at 8:46 am #Niolani

    My house was burned down yesterday and everything was ruin. My owner have homeowner insurance. I do not know yet what cause the fire but no one was at home and the gas was already turned off. Last week the landlord changed the locks to the house, with all my stuff still in it. So I believe someone set the fire or it was faulty wiring in the because the kitchen light do not have a switch to turn off, so it is on all the time. Now can the landlord claim this fire and receive any money or am I entitled to any compensation for my stuff that was in the home?

  800. October 22nd, 2011 at 8:56 am #Jason

    Niolani,
    From what you posted, you don’t seem to have renters insurance. Any insurance the landlord would have is for his benefit and not yours. So, if you don’t have an insurance policy, you have suffered this fire loss by yourself.

  801. October 23rd, 2011 at 2:55 pm #jenny

    my homeowners association is trying to get any left over money from a claim for a loss in my unit, is there any hoa law/ruling you can give me?

  802. October 23rd, 2011 at 3:12 pm #Jason

    Jenny,
    Why are they involved with damage to your unit? If they don’t have the funds, how can they get them?

  803. October 23rd, 2011 at 3:16 pm #jenny

    because it’s the HOA insurance, i have my own homeowners but being in a condo the HOA insurance is the primary insurance

  804. October 23rd, 2011 at 3:39 pm #Jason

    Jenny,
    It’s their claim so it’s their money for the repairs. Many people don’t understand the relationship between the association policy and their own policy and what each one covers and doesn’t cover. If your unit is fully restored, don’t worry about any left over money.

  805. October 23rd, 2011 at 4:01 pm #jenny

    thank you for the quick response, i do understand what you’re saying but i do pay for that insurance too with my association fee.

  806. October 23rd, 2011 at 4:19 pm #Jason

    Jenny,
    Then any left over funds should go to the association fund for the benefit of all the unit owners, not just you. Think about it.

  807. October 23rd, 2011 at 4:30 pm #jenny

    thank you, you’ve been very helpful, i wish i can tell you more details that’s why i feel the way i feel but i can’t, just the same i really appreciate the time
    jen

  808. October 24th, 2011 at 12:28 pm #David's Wife

    Jason,

    The wood in question is about 130 years old – We found it in an 1870s barn, cleaned/repaired/restored it, and had it installed throughout our home. It is not a typical “Bruce Hardwood” or “3/4″ handscraped” version – It is truly original/unique. We have enough extra boards to replace about 1/2 of the water-damaged area.

    Please don’t think me rude (not my intention at all), but do you mind if I ask if you are an adjuster or work in claims? If not, what is your insurance background? Just trying to figure out if these are issues you have dealt with on a professional basis, or if the answers are a layperson’s opinion.

    Thanks again for your help.

  809. October 24th, 2011 at 4:07 pm #justme222

    David’s Wife,

    If I may: I am contractor that deals with insurance claims all the time. From my personal experiences, if the floor cannot be matched the insurance company would normally replace the whole floor, but only if you fight nicely. The important factor too is “HOW” the contractor draw up the estimate for damages. This is not an impossible task, but be careful how you go about it. Good luck finding a lawyer that would take such a case. It is my feeling that you can handle this yourself….smile!!!

  810. October 24th, 2011 at 6:48 pm #Jason

    David’s wife,
    That is ok, you can ask my insurance background. I am perfectly fine with that. With my education, knowledge, and experience, I am qualified to answer every single question submitted on here. I never provide opinions but I do provide straight forward answers about every situation presented.

    Now, to address your question – the policy is frankly very rude when it comes to repairing or replacing items that are damaged. In your case, the insurance company can buy new hardwood floors and install them in your house. However, they cannot age the wood to be 130 years old. That is not possible. The policy addresses this with antique or outdated items in that they will be replaced with items that are new because it is basically impossible for the insurance company to buy an antique or aged item since that requires the passage of time and because of that, there is not a readily available market for those kind of things. There are policies that have wording that dictates that the insurance company can use common and current methods and materials for repairing damage to a home.

    Now, the other aspect of this is matching. There is case law all over the board that indicates what a reasonable match is. For example, exterior siding does not have to match any further than an inside or outside corner (variance in shade due to differences in color lots). The insurance company will both win and lose arguments about this and other items (flooring, walls, construction methods) involving the repair of a home. The insurance companies can hire dozens of lawyers and spend tons of money defending their position just because they have so much of it at their disposal. And if they want to get something tangled up in court to prove a point or get their way, they have the time, resources, money, and attorney’s available to them that a typical insured does not have at their disposal.

    So, David’s wife, work with this adjuster. They are your direct link between your insurance company and you. They can bend for you and make things go smoothly or they can make it very difficult. Be polite about your position, provide the adjuster with solutions, options, and assistance. The thing is that you don’t want to be pushy, demanding, or otherwise difficult to work with. Basically what the adjuster recommends is what the insurance company generally goes along with.

  811. October 25th, 2011 at 5:34 am #Leah

    We have a detached garage that collapsed on 9/28/10 because of wind. File claim with allstate, almost a month later we were denied the claim where the adjuster were saying that the garage itself is already deteriating and that it needs maintenance. Can I appeal this? and if so what would be the route to go?

  812. October 25th, 2011 at 7:51 am #Jason

    Leah,
    It’s odd that you used the term collapse when referring to an action caused by wind because wind, for the most part, does not collapse things.

    Your policy is probably very similar to most policies which contain a concurrent causation clause. To put this term in simple words, it means if a non-covered cause of loss (deterioration, in this case) happens at the same time a covered cause of loss (wind) takes place, then coverage does not exist for the entire event. It also has wording that it doesn’t matter in what proportion each event contributed to the loss.

    Sure, you can appeal it. You may want to bring this to a claims manager’s attention by calling and/or writing. Point out that there are many garage conditions from brand new to very old and that wind damaged your garage just like it would have damaged any garage in this range. However, if your garage indeed collapsed, you may not want to waste your time or that of anybody else.

  813. October 25th, 2011 at 8:00 am #Jason

    Leah,
    Also, since you have a specific date when this loss occurred, you can go to a site called weatherunderground.com and do a historic weather search (which has weather condition reports in 15 minute increments) for your specific location and provide this data as support for the strength and/or duration of wind on that date. If there are reported winds or wind gusts 40 mph or higher, this will bolster your case. However, if there was hardly any wind conditions or the wind gusts were not very high, then it’s very likely this will not help. If you need more details about this site, just ask, but please review the site first before re-posting.

  814. October 25th, 2011 at 11:04 am #David's Wife

    Just Me,

    Thank you for that insight. =) We have tried being polite but firm, but our patience is wearing thin, as this has now been going on for four months. The adjuster will not budge, and states that the company which actually caused the damage has a policy with them that simply doesn’t include repairing areas that can be “blocked off with doors.” ie. bedrooms, the study, etc. Not fun.

    Jason, if you don’t have any experience working directly with/for insurance companies, you should probably state that in your replies; it would be a shame if you gave someone the wrong advice and they took your word for it. I know you are only trying to help, but I think you might want to be more careful with the way you word your answers.

    Thanks again !

  815. October 25th, 2011 at 3:53 pm #Jason

    David’s wife,
    If this has been going on for 4 months, what you are presented with by this insurance company is likely the best arrangement you will get from them.

    You have 2 options. The first is to accept what they offer and move on with life or the second option is that you can present this to your insurance company and see if their remedy is any different than what this insurance company is offering.

    When all is said and done, your insurance company will recover the ACV value from the at fault insurance company (including your deductible) and forward your deductible to you. Don’t worry if your premiums will go up because sometimes claims cannot be avoided.

    I have plenty of experience working with contractors, insurance companies, and attorneys for and against insurance companies. (Please see the last post concerning adequate education, experience, and knowledge). If people want relevant and reliable information they will get it here and I am not going to justify every single detail why my information and replies are accurate. The information I provide is accurate and reflective of the information I receive about each circumstance. Luckily, you have the option to disregard any and all information I post.

  816. October 25th, 2011 at 6:54 pm #justme222

    David’s Wife,

    You should actually ask your insurance company for a copy of the pamphlet which state claims about the doorways, etc. . Sometimes adjusters will flat out tell a lie if they feel they can get away with it. Sad, but true. It happens all the time. I had an adjuster even tell a client that they did’nt even have insurance with them because he knew all the paperwork had burnt in the house. Sounds crazy, but that’s a true story. So I said all that to say: Have the insurance company show you what they say in writing, cause they may be lying to you….but maybe not. Just check it out. Good Luck!!!

  817. October 26th, 2011 at 7:09 am #David's Wife

    Just Me,

    *Wonderful* idea to ask the insurance co for a copy of the info and exclusions the adjuster is spouting! I wouldn’t have thought of that – Thanks! =)

    I’ll post the result here when all is said and done – Perhaps it will help someone who is in the same situation.

  818. October 27th, 2011 at 6:35 am #J Hicks

    My patio door leaks and has caused damage to the floor and the room below. The insurance company has covered the water damage below. I have had a contractor in to make a repair to the door but it still leaks. Should the insurance company cover the costs to replace the door with a new one. It appears the design of the current door is poor and cannot be repaired.

  819. October 27th, 2011 at 8:18 am #Jason

    J Hicks,
    The design of the door seems inadequate not to be causing damage to other parts of the house. That is a manufacturing issue with the company that made the door. Insurance doesn’t pay for poor design or defects in products.

    If you want to get a new patio door, you would have to ask the homeowner to replace it with a new one.

  820. October 27th, 2011 at 12:46 pm #catherine mcnciol

    I phoned my insurance company about my brick exterior wall , I found that the brick walll was cracked from top to bottom , I put in a claim , and I am waiting for the enspection of the wall to take place soon , can anyone tell me the chances of the wall being repaired My frind told me that they will just tell me that it is wear and tear of the property and this will get them off from covering my claim thank you actherine

  821. October 27th, 2011 at 2:28 pm #justme222

    Catherine,

    If the wall is broken from just wear and tear then no you are not going to get coverage for this claim. It would be different if it was hit by a car or was caused by a storm or something, but if that’s not the case you are out of luck.

  822. October 27th, 2011 at 2:46 pm #RyanL

    We have Farmers Insurance (Yikes!) and we had a exterior fire that started in our garbage can on the outside of our house and ruined part of our siding. Our adjuster seems to think they will be able to exact match our siding even though our existing is 6+ years old. He even tried suggesting that if it was a close match they could shuffle some of our existing siding around so that it blends. We are not happy! We live in IL. Any advice?

  823. October 27th, 2011 at 5:45 pm #Jason

    Ryan,
    At minimum you should be provided an allowance to remove and replace the damaged siding from inside/outside corner to inside/outside corner. That way if the shading is a little bit off in the same siding product, it won’t be noticed.

    Work with this adjuster to arrive at a plan that you can accept. When all is said and done with the repairs, you should have to pay no more than your deductible and you should not know there was ever any damaged siding on your home.

  824. October 29th, 2011 at 1:55 pm #zagyzebra

    My home was rented to a high-profile person (regularly in headlines) who was extremely negligent with candles (thousands of candles in combustible places found after the fire) and the home burned in a large loss fire in November 2010. Her renters insurance company has accepted liability. She also has a general liability umbrella policy. My insurance company is about to pay to term limits, but still, the damage was so extensive it will not cover complete restoration of my home.

    My questions:
    1) In your experience, under such circumstances, would I be advised to take an attorney to deal with her two insurance companies to handle the “many forthcoming negotiations and discussions?” (Their words.) Will I stand to gain more as a result of an attorney intervening on my behalf? Will the gain be sufficient enough to offset the 25% paid to my attorney?
    2) I personally estimated the value of my contents and expect to be compensated for my time (I rented the house to the tenant fully furnished). I also expect to be compensated for my time spent meeting with contractors and that which will be spent supervising the construction and interior design, because this fire happened as a result of her negligence and these are responsibilities I would not otherwise have. Is this something her insurance companies will pay for, or will I have to take her to court and sue her personally for this?
    3) I will have to move from one state to another in order to supervise the restoration of a special historic home. I expect to be compensated for my increased costs resulting from this move. Is this something the insurance companies will pay for?
    4) I cannot start construction until her insurance companies pay out, because my insurance is not paying enough to cover complete restoration. I expect her insurance companies to pay my loss of rent while I wait for them to pay out, and yet, her primary insurance company has said I have a responsibility to mitigate my damages. How can I mitigate damages caused by their client to my home when I do not have enough money in hand to complete the construction? I refuse to start and stop construction midway through, just as they refuse to pay me until subrogation has been finalized. Additionally, since I will be losing rental income while they evaluate the claim, I expect her insurance companies to reimburse me for interest I would normally collect on monies I will have withdrawn from my personal investment portfolio. Is this something insurance companies will pay on?
    5) Pain and suffering. This loss has consumed me and my family for the past year and will continue to for at least another year or two. I expect to be compensated on some level for pain and suffering and have kept a daily journal documenting my hardships. How do insurers view pain and suffering pay-outs? What requirements must be met to be entitled to a pain and suffering pay-out?

    I realize these are many questions. However, your answers will benefit not only me but others in the future presented with similar difficult circumstances.

  825. October 29th, 2011 at 2:24 pm #zagyzebra

    I have one additional question: Under what circumstances would an insurance company that is accepting a third-party liability claim offer Receipt for Advance Payment?

  826. October 29th, 2011 at 3:00 pm #Jason

    Zagyzebra,
    1. You will have to evaluate how much benefit you can gain from an attorney doing this for you. That is not an analysis we can do for you.

    2. Her insurance company won’t pay for your time to estimate anything. If you sue this person, the courts will award you nothing for your for time to estimate the value of your property.

    3. Your expectation of being reimbursed for increased moving costs will not be fulfilled.

    4. Your expectations will fall short of reality concerning this as well.

    5. You will not meet any of the requirements needed for pain and suffering. First, you have not been injured and because you have not been injured, you have not suffered. There will be no compensation for this unrealized condition.

    6. The receipt for advance payment is just that – a receipt.

  827. October 29th, 2011 at 3:48 pm #Marty

    We have a homeowner’s claim on-going to restore kitchen damage. The independent adjuster told us he recommended to HARTFORD that all cabinets be replaced and priced his est that way to them. But the version we got from HARTFORD had only half of the cabinets replacement. And HARTFORD tells me to have my contractor submit a separate estimate to do what we think is the complete job. So they need double verification before they will be convinced what the total job involves?? And of course they don’t admit scrubbing the adjuster’s est. Is this low-balling the est std practice?

    Thanks

  828. October 29th, 2011 at 5:04 pm #Jason

    Marty,
    We don’t have enough information to determine what happened with your kitchen. The policy coverage you have with your insurance company is for direct damage to your cabinets. Sometimes it’s easier for an adjuster to replace the entire lot of cabinets than do part of the kitchen so that is likely what happened.

    I don’t know what they are requesting you to do to get another estimate from your contractor because the existing estimate should be sufficient to work from.

    There is no indication that “scrubbing” occurred. There is also no indication that low-balling occurred.

  829. October 29th, 2011 at 5:24 pm #Marty

    Thanks for the reply.

    The indication that scrubbing occurred is my personal conversation with the adjuster who said “replace all cabinets” and submitted same to HARTFORD and the resulting est I got from HARTFORD WITH THE ADJUSTER REFREENCED saying replace half of the cabs. Something happened in between. The cabs in question have bubbled and smoke damage AFTER Servepro did their cleaning work.

    Also, I was told there is a 2 yr window for reopening a claim. How does one allow for that flexibility without giving up that right?… not sign any “everything is done” paperwork (whatever form that will take)?? Thanks again.

  830. October 29th, 2011 at 5:31 pm #Marty

    The cabs NOT on the list for approved replacement had bubbles and smoke damage AFTER Servpro did their cleaning.

    The claim arose from a grease fire the tenant had on the stove (the cab side not slated for replacement) who then dribbled boiling oil on the lino to the sink where it flamed up and scorched cabs on that side, as well as the vinyl window and recessed light.

    My understanding is there is a 2 yr window for keeping a claim open. What paperwork should one sign or not sign in the form of a release to preserve that option?

    Thanks again!!

  831. October 29th, 2011 at 5:34 pm #Marty

    …and the adjuster told me personally he said replace all cabs and the output from the ins est summary was for partial replacement. So something got dropped in between…call it scrubbed…lo-ball…take your choice…or oversight.

  832. October 29th, 2011 at 5:52 pm #Jason

    Marty,
    I am not there to determine what needs to be replaced and what doesn’t.

    You may want to get a better understanding about the time frame you have for your claim to be completed. That is especially important if you have replacement cost coverage because it is common for that time period to be 180 days.

    I don’t know to what you are referring when you ask about what to sign or what not to sign. That might be a question for an attorney.

    The adjuster may have over-extended the required scope to repair what needs to be repaired in the kitchen. Again, nothing in your post indicates there was scrubbing or low-balling.

  833. October 29th, 2011 at 6:05 pm #Marty

    The adjuster was the ins co arm for determining what needed to be done to restore the unit. The ins co paid him good $ to make the assessment. For the ins co to short the est would have required a 6th sense on their part.

    On the limitations to reopen a claim, I anticipate I will have to sign a “satisfaction” form, like I did with Servpro, and if I do that will I lose future capability to open the claim again if something unforseen is discovered? Seems like there should be some standard procedure where you either buyoff what has been done, or you defer until a period has passed that convinces you nothing was missed in the restoration estimate.

    Thanks.

  834. October 29th, 2011 at 6:22 pm #Jason

    Marty,
    The insurance company likely paid the adjuster for his assistance. That seems reasonable. The statement that the only way an estimate can be corrected is to have a 6th sense is an inaccurate conclusion. I can accurately settle a severe claim if I have sufficient photographs and measurements. That doesn’t require any special skills – just experience and know-how.

    Don’t worry about opening the claim in the future. Make the effort right now to make sure everything is completed as it should be. Then stop worrying about opening it in the future because you should have no need to do that if your claim is completely settled right now.

  835. October 29th, 2011 at 6:34 pm #zagyzebra

    Jason – You’re in the insurance business, right? In your experience, do attorneys generally help their clients boost the settlement amount for third party insurance claims…yes, or no? And if yes, by how much generally?

  836. October 29th, 2011 at 6:43 pm #Marty

    Jason,

    So apparently the adjuster the ins co paid did not provide sufficient info to validate his complete claim that all cabs should be replaced. So, guess I get the priveledge. Perhaps more interaction between the ins co and their hired adjuster would have been warranted so I wouldn’t have to fill in??

  837. October 29th, 2011 at 6:47 pm #Jason

    I have adequate experience and knowledge in construction, business, insurance, and law that I know what I am doing.

    If you want a yes or no answer, the one I will provide is no, not with property claims.

  838. October 29th, 2011 at 7:01 pm #Jason

    Marty,
    I don’t know how many cabinets need to be replaced. I don’t know to what extent they are damaged. I don’t know what remedy would make things better regarding your claim. I don’t speculate on things such as communication levels, I provide information about insurance.

    Some insured’s are more involved in their claims than others. You seem to be more involved than others but that is just an observation. If you have cabinets that are damaged that are not being replaced, have those cabinets addressed. I’m sure you will but you have to relay that to your insurance company, not us because we’re not handling your claim.

  839. October 30th, 2011 at 7:14 am #(Alexis) David's Wife

    To Zagyzebra,

    I read your post and would like to offer some advice. In my opinion, you have way too much to lose to *not* have an attorney present at each step of this process. If possible, I would recommend hiring an attorney who charges by the hour instead of taking a contingency fee. I can’t stress enough the value of finding a really good/knowledgeable attorney for this situation; there is so much at stake here and so many unknowns for you that I think it’s an absolute must.

    With all due respect to Jason’s ‘expertise’ – I disagree with part of his response. It is impossible to say for certain what verdict a jury and/or judge would find in your case. It is also impossible to say with finality what an insurance company will or won’t pay for (of their own accord or compulsorily). These are not questions that can be answered with common sense (too many loopholes, legalese, and simply too many variables in your case). I think this forum is a hobby for Jason and I wish that he would stop answering questions as if his answers are the final word; I think he is doing a disservice to some of the people seeking help here, regardless of his “education, knowledge, and experience.”

    Regarding suing your tenant. You may or may not qualify for Pain and Suffering damages (honestly, probably not), but if the tenant literally had hundreds or thousands of candles burning in your home, I think you have a good chance of recovering in the form of punitive damages. There is also the publicity factor; if this person is indeed in the headlines regularly, she probably will not want a suit made public and might be motivated to settle in your favor quietly.

    I hope this helps (again, it is only my opinion), and I wish you the very best of luck. I can tell from the tone of your posts that this has really taken a toll on you and your family.

    Regards,

    Alexis

  840. October 30th, 2011 at 8:44 am #Jason

    Alexis,
    There is not a single attorney in the country that will accept a case of this nature on a contingency basis. Attorney’s are not necessary for a contract to be entered into and completed by 2 parties. Contracts are made everyday and attorney’s are not necessary for the end result to be reached. (Some exceptions apply but Zagyzebra has provided no information to conclude that one is needed.)

    I don’t provide opinions, just facts based on the information presented. Now to indicate that someone may or may not qualify for pain and suffering when it is clear that they don’t is completely reckless. In order for pain/suffering to be a factor, there needs to be an injury. With Zagyzebra, there is no injury. Absent the principle requirement for pain/suffering, it will not even be considered. That is a fact.

    Punitive damages are awarded to prevent a future activity from being repeated. There is nothing illegal or even unethical when a person lights candles. This applies to 1 candle or thousands of candles. To suggest to someone they may recover punitive damages is careless and that in itself will cost thousands of dollars if a person follows your advice.

    If you want to support that Zagyzebra would have “a good chance of recovering in the form of punitive damages”, please post case law or at least one published legal opinion that supports your statement. I know nothing will be posted because there is absolutely no case law and no published legal opinions to support this.

  841. October 30th, 2011 at 9:57 am #(Alexis) David's Wife

    Jason I’m not going to argue with you, as I believe you tend to make up your ‘facts’ as you go along (rendering an intellectual discussion with you impossible). Basic layperson’s knowledge of the law, combined with your trusty thesaurus, does not make you an attorney, or an expert on insurance claims.

    I took Just Me’s advice and emailed the insurance company’s adjuster (ins co for the company that damaged our hardwood floors) for a copy of the exclusions section in that company’s policy, and also let her know that we were probably going to secure counsel. The adjuster called me back within 24 hours; they are going to pay the full amount of our contractor’s original estimate for full replacement of *all* hardwood floors. If I had listened to your advice about the impossibility of matching hardwoods, and further, to just let the insurance company replace the damaged portion only, we would have been out thousands of dollars to continue the repair to the ‘excluded rooms’ ourselves. This is why I don’t think you should be giving absolute advice. Really, it’s as simple as making a notation that it’s *your opinion only* and should not be relied on as the ultimate answer.

    I logged on to thank Just Me for the great advice – Saved us a lot of $$. =) Thank you so much!!

  842. October 30th, 2011 at 11:36 am #admin

    Alesis, Jason, and contributors,

    Thank you all for your participation and expertise. Agree or disagree with Jason, no one can deny the selfless contribution of his time here. While the inclusion of “IMO” might not be a bad idea in his posts, it’s not a huge flaw, IMO” 🙂 , considering his contributions.

    So often there are several strategies in proceeding with a claim, and the strategy can change with every communication. All one can do is pick one and hope it works, “a judgment call”. The fact that there are differing opinions can only improve this website.

    Thank you all for your participation. You are welcome to include links to your own websites and business contact info. at the end of each post.

  843. October 31st, 2011 at 7:51 am #Paige

    We recently had our second house fire within 4 years. The fire started in a basement closet. From what State Farms fire investigators finding he believes arson(no cause). We hired our own fire investigator to see if he had the same conclusions. Our fire investigator said that there was no know causes for the fire in the closet (ie arson)… however he went on to say that in his opinion my husband and sister started the fire. Which is not true, noone was even home that day. We just submitted our proof of loss and now the insurance company wants to do an examination under oath. They also want authorization to speak with the fire investigator we hired, and I was told by state farm if I do not give then autho they will deny the claim. I have given everything they have asked for except I hate to give them autho to speak to the person I hired who thinks we started the fire based on his “opinion”.

    Additionally State Farm has set our EUO for the end of next month can I do anything to get it moved up since this is taking forever I am running out of savings replacing my children clothes, toys and additional living exspenses since state farm will not approve or deny my claim for contents.

  844. October 31st, 2011 at 9:16 am #Jason

    Paige,
    You have provided a lot of information in 2 short paragraphs. A fire investigator’s basic goals are to determine cause AND origin. Apparently they have the origin narrowed to the closet. From the information you provided, I can’t determine if origin is more defined than that.

    The other aspect of what these fire investigators do is determine the cause. (example: What caused the fire?). In your case, and with the information you provided to us, the State Farm investigator has determined cause. His conclusion is arson (arson, meaning intentionally started).

    Does the State Farm investigator know exactly how the fire was caused? We don’t have enough information to determine that. However, he concluded it was not accidental so we can rule out all accidental causes based on that conclusion.

    You hired another investigator for your piece of mind. He has concluded the same thing that the fire was intentionally set, and it originated in the down stairs closet. This 2nd C&O (cause and origin) person has theorized that your husband and sister started the fire. (He opined that both your husband AND sister started the fire, which is indicates he has more information than he has presented to you.) This is a very specific conclusion because the origin of this fire literally rules out all persons who did not have interior access to your home and focuses at 2 people, but not you.

    In reference to your C&O person, you may want to provide authorization to State Farm. A professional’s opinion has more weight and bearing than a lay person’s opinion. In fact, your C&O person’s opinion is likely the same opinion as the State Farm’s C&O, but you just haven’t been notified of that yet.

    Fires are very difficult to start in a home. Two fires occurring in a home within 4 years is nearly impossible, unless one or both fires are started intentionally.

    Concerning your savings – based on the information you provided, you may want to prepare for a denial.

    If you had nothing to do with this fire, you may want to review information concerning an innocent co-insured. A brief introduction to this concept can be found at http://www.tedfordpond.com/hot-topics/the-innocent-co-insured/

    Additionally, having an attorney in your corner is a good idea. You may want to secure an attorney for yourself. (The attorney you retain should represent only you, and not your husband.)

  845. October 31st, 2011 at 10:23 am #bob

    .

  846. October 31st, 2011 at 11:42 am #Morgne

    I bought a house in poor repair several years ago. After I purchased the house it became evident that it passed “poor repair” and became a “reasonable tear down”.

    I had been renting it out inexpensively to some college kids while waiting for the market to raise enough to get me in the clear to put it back on the market.

    There was a chimney fire last week. I refinance the property for 175,000 six months ago, with the property alone equating to 100,000 of that value. The initial vague estimates for repair are in the 50,000 – 80,000 range but only repair about 60% of the house. The rest would remain in “tear down” status. Rather than put all that work into a house that is still extremely not-so-good (it was badly built 100 years ago with little to no upkeep since then) I’d rather just tear it down and rebuild later when I have the money to kick in to build a nice house.

    That could be years down the road however.

    My two questions are: If I don’t want to rebuild, can I just give the mortgage company whatever the settlement would have been to pay down the mortgage to a “lot” only amount? That way they remain secured by the lots equity. If so, and the insurance company would pay 50,000 to rebuild can they pay that 50,000 to the mortgage company or would they only pay ACV to the mortgage company?

    Two: If they do pay ACV only my fear is that it will be a very small amount because the house wasn’t so great to start with. What type of percentage do they usually depreciate older houses that didn’t recieve a lot of upkeep?

    Thanks everyone!

  847. October 31st, 2011 at 12:05 pm #Jason

    Morgne,
    If this is a rental dwelling, the coverage on it is likely only for ACV. That means whatever the cost of repairing will be depreciated to arrive at an ACV repair. On an old, un-maintained house, the depreciation could be 75%. So, if the repair to the home is $50,000, you will be provided with $12,500 to make the repairs that cost $50,000.

    Talk to your mortgage company about your options.

  848. October 31st, 2011 at 12:10 pm #Morgne

    Jason,

    We have Replacement coverage on the home. Does that change anything?

    Morgen.

  849. October 31st, 2011 at 12:24 pm #Jason

    Morgen,
    Yes, it does. You will be allowed to make the repairs with an initial AVC value payment to you and then you can collect up to the full cost of repairs indicated on the estimate when the repairs are completed. You will have to make the repairs within a certain time period. Also, you have to make the repairs to collect the replacement amount.

    Getting half your house updated with new materials rather than collecting $15,000 (in the example) makes much more sense. The mortgage to the bank will not just go away. It will need to be paid and a good way to do that is if you have this property producing rental income to do that.

  850. October 31st, 2011 at 1:19 pm #rob

    I have builders risk insurance on a home that I am building with a $1000 deductable, but I never received a copy of the policy or the endorsements — just a declarations page. I renewed the policy this September (2011), but still no copy of the policy or endorsements. Now I have a wind damage claim, and I am finding out that there is a $4000 deductable on wind damage. I reside in massachusetts, but the home I am building is in north carolina. I was really suprized at the amount of the deductable for wind damage. Is there any rule that says that they are supposed to provide a copy of the policy and endorsements to the insured?
    Thanks
    Rob

  851. October 31st, 2011 at 1:50 pm #Jason

    Rob,
    I’m not aware of any rule. It does make sense to get a copy of the contract that you enter into with someone or a business.

    If you don’t have a copy of the policy or endorsements, why don’t you ask for a copy so you can review your coverage.

  852. October 31st, 2011 at 2:09 pm #admin

    Paige,

    In addition to whatever opinions you may get on this website, you and or your attorney would be well advised to get the special eBook on EUO (Examinations Under Oath) Deluxe from UClaim.com.

    As to your own investigator, if it was me, I myself would not “volunteer” that I had my own investigator, or his opinion. However if you are asked if you had your own investigator, then you have to disclose the information. You should ask a lawyers opinion on that. I’m just telling you what I would do if it was me. The final decision is yours.

    Now if the fire was “arson” and it was indeed set by your husband or sister, was it with the intent to defraud the insurance company and to get insurance money? Was it revenge? Was it for fun? Was he mentally ill? There is all kinds of case law in most states that may or may not override the insurance policy in your case. So getting an attorney will be of help in many ways. And an attorney can stop a 2 hour EUO from becomming a 2 day EUO.

    And is there an “innocent spouse” clause in your policy that would cover your interest in the property even if your husband set the fire? And if not, there may be case law that overrides the policy in your favor. Get an attorney and get the eBook on EUO. And by the way, 99.9% of attorneys don’t know the important differences between EUO and depositions.

  853. October 31st, 2011 at 3:15 pm #rob

    Thanks Jason…

    I did that the minute that I found out that the deductable was higher than I believed… It’s going to take weeks to get a copy……It just seems sort of deceptive that they never sent the policy or the endorsements to me… I guess I sort of relied on the fact that in every other instance where I bought insurance, they sent that type of info to me. I feel like I was taken advantage of. I think it is unfair that they are bringing up a deductable that is 4 times higher than what I thought it would be, and this is the first time that it was brought to my attention (other than in the fine print i.e. “this policy is subject to endorsement #hb1253…”). Maybe I’m stuck with the deductable, but it seems that there should be a rule requiring insurance companies to automatically send a copy of the policy and any endorsements to the purchaser… I guess I’m just confusing the familiar with the necessary.. thanks, Rob

  854. October 31st, 2011 at 5:55 pm #Jason

    Rob,
    A home ideally should be built in 3-6 months. If it takes longer than that, there may be problems. The odds of a claim being submitted on a new home construction is higher than for homes that are completed within 6 months..

    It may just be the approach the insurance company takes to reduce or eliminate claims for their risk of this type when a renewal is needed.

    Your agent should be telling you this because it’s kind of important.

  855. November 1st, 2011 at 9:20 pm #Jazzmen

    I have ins with farmers and my home was burgalrized in aug of this year i went thru all of the procedures they ask of me i even did an EUO and when i went to the mediation the lawyer was concern about me filing bankruptcy chapter 13 in 2010 and ask me why i didnt list my items i had on my ins list for bankruptcy i told him i didnt think i had to put my personal items down..Can farmers deny my claim for filing chapter 13? and i dont have any items on my bankruptcy form my policy is 30,000 for contents but my lost was for over that limit

  856. November 1st, 2011 at 9:45 pm #Jason

    Jazzmen,
    No, they can’t deny your claim for filing bankruptcy but they can deny it for not accurately claiming something or providing false information. We don’t have enough information about your situation to provide any further details to you.

    I can understand why the insurance company did an EUO. Generally burglaries are specific and carried out in a short amount of time. In order to remove over $30,000 worth of property from your house does not meet the typical conditions of a burglary.

  857. November 2nd, 2011 at 4:12 am #Ana Stanic

    Hello,

    First of all, thank you soooo much for helping all of us. Since I had to move from Florida I had to rent my condo, which has been insured by Fidelity for years now. I noticed that one of the categories under premium is for Personal Property-30K, and that makes my premium go up quite a bit. When I called to lower that category to 15K a couple of years ago, a very pushy rep told me that personal property is everything that is not the walls itself inside(condo association covers the outside of the building), such as bath tab, kitchen cabinets, appliances…I just do not understand how that could be considered personal property? The place is rented, and I have no personal property in the condo. Am I right to doubt that a toilet bowl is considered personal property or am I being lied to? Thank you so much in advance.

  858. November 2nd, 2011 at 9:13 am #Al

    I have Allstate insurance for my home owners insurance. I recently suffered a major water damage loss. Allstate has recommended using their preferred contractor who will be paid using their alacrity system. I’m wondering if there is any benefit by finding and using my own contractor rather than the preferred contractor. The Allstate adjustor makes it sound so easy since they would pay the contractor directly through the alacrity system and I won’t have to worry about setting up my own account and dealing with possible liens. The Allstate adjustor says that the work is guaranteed for 3 years and with no possibility of liens when work is completed.

  859. November 2nd, 2011 at 9:40 am #Jason

    Al,
    It’s entirely up to you. You have the option of using their preferred contractor or your own. This is a matter of personal preference.

  860. November 3rd, 2011 at 6:55 am #Deborah

    I have homesite insurance , I have the sump pump endorsement that will max out at $5000.00, our basement was fully finished, our 18 year old daughter lived there, and then we were hit with Irene. We lost power for three days and the sump pumps turned off. When we got home the floor was almost dry but our walls and furniture , clothing and appliance were wet and started to developed mold ( we also have the mold limited fungi, wet and dry rot or bacteria coverage) . We think about 1 to 2 feet of water entered the house due to the sump pumps being off. now my question, is my damaged property ie. clothing, furniture and appliances covered under the property coverage endorsement, and the Sump Pump Failure/Sewer Backup Loss cover the walls and the amount it is going to cost to fix the place back again? or is the $5,000 the max on everything in the basement?

  861. November 3rd, 2011 at 7:16 am #Jason

    Deborah,
    Jumping right to the sump pump endorsement isn’t the right process to figure out your policy. We don’t know enough about your situation to provide an answer. If your policy didn’t have a part in it that said if a covered cause of loss AND a non-covered cause of loss occur at the same time, regardless of either one’s contribution, then the entire loss is not covered, it would be much easier to address your question.

    The mold, fungi, and bacteria coverage is triggered if these conditions arise from a covered cause of loss that is not excluded. We don’t know enough about your claim for this either.

    Irene occurred some time ago. What feedback are you getting from your insurance company?

  862. November 3rd, 2011 at 7:37 am #Deborah

    I just had a second adjuster out yesterday, the first one didn’t include my damages to the basement as he said he didn’t know we had the sump pump insurance in the policy. Although he did see the basement and take pictures.
    I have called them and dont get an answer, always the answering machine , I leave messages and no one calls back. I have even emailed them.
    I have HO 04 90 0491 Personal Property Replacement Cost

    and this is the page for the sump pumps

    THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
    WATER BACK UP AND SUMP OVERFLOW
    1. For an additional premium, we insure, up to
    $5,000, for direct physical loss, not caused by the
    negligence of any “insured,” to property covered
    under Section I caused by:
    a. Water which backs up through sewers or
    drains; or
    b. Water which overflows from a sump even if
    such overflow results from the mechanical
    breakdown of the sump pump. This coverage
    does not apply to direct physical loss of the sump
    pump, or related equipment, which is caused by
    mechanical breakdown.
    This endorsement does not increase the limits of
    liability for Coverages A, B, C or D stated in the
    policy Declarations.
    2. Special Deductible
    The following deductible provision replaces any other
    deductible provision in the policy with respect to loss
    covered under this endorsement.
    We will pay only that part of the loss which exceeds
    $250. No other deductible applies to this coverage.
    This deductible does not apply with respect to
    Coverage D – Loss of Use.
    3. Section I – Perils Insured Against
    In Form HO 00 03, paragraph 2.e.(2) under
    Coverage A – Dwelling and Coverage B – Other
    Structures is deleted, with respect to coverage for
    loss caused by overflow of sumps, and replaced by
    the following:
    (2) Inherent vice, latent defect;
    In Form HO 00 15, this is subparagraph 1.b.(4)(b);
    in HO 17 32, this is subparagraph 2.e.(2).
    4. Section I – Exclusions
    3. Water Damage is deleted and replaced by
    the following:
    3. Water Damage, meaning:
    a. Flood, surface water, waves, tidal water,
    overflow of a body of water, or spray from any
    of these, whether or not driven by wind; or
    b. Water below the surface of the ground,
    including water which exerts pressure on or
    seeps or leaks through a building, sidewalk,
    driveway, foundation, swimming pool or other
    structure.
    Direct loss by fire or explosion resulting from water
    damage is covered.
    (In Form HO 00 03, this is item 1.c.)
    All other provisions of this policy apply.
    This is a Policy Snapshot
    Limit
    Property Coverage

    Dwelling
    Your dwelling is protected against Extended Incidents

    $375,000

    Other Structures

    $37,500

    Personal Possessions

    $187,500

    Your computer(s) are protected against Extended Incidents
    All other possessions are protected against Standard Incidents

    Full Replacement Cost Coverage

    Included

    Temporary Housing Expenses

    $75,000
    Liability Coverage

    Personal Liability

    $300,000

    Defamation of Character Liability

    Included

    Medical Payments to Others

    $3,000
    Additional Coverages

    Water Backup & Sump Overflow Protection

    $5,000

    Mold Property Coverage

    $10,000

    Mold Liability Coverage

    $50,000

    Identity Theft Expense Protection

    Included

    Earthquake Protection

    Included
    Deductibles

    Regular Loss

    $2,500

    Sump Pump Failure/Sewer Backup Loss

    $250

    Identity Theft Expense Loss

    $250

    Earthquake Loss

    $18,750

    I hope this helps, I asked the adjuster when he came out yesterday what is the hold up and he just shook his head and said he is Independent and knows they have a lot of work.

  863. November 3rd, 2011 at 12:22 pm #Jason

    Deborah,
    It’s not necessary to post your policy on here.

    The best person to ask questions you have is your adjuster. We don’t know how the damage occurred. We don’t know if the water is flood water that entered your home, water that backed up from your sump pump, or water seeping through your foundation. Not all water entry into a home is covered.

    What I’m saying is that we cannot adjust and settle your claim on here. That is why the adjuster(s) visit your home. The adjuster also provides the insurance company with an estimate and recommendation about what they suggest to settle your claim.

  864. November 4th, 2011 at 11:48 am #Judith

    Hi,
    I had ash and soot damage to my property after SoCal wildfires and filed a claim with a public adjuster in to Fidelity in order to have the home properly cleaned, since my house was supper dusty and I did not want my newborn breathing the air. Unfortunately I could no longer make the payments of the home and was foreclosed on with the claim pending. I received the check for the cliam after I was no longer the owner and status that they were still trying to negotiate for additional losses and I could enter into a litigation. Could I get in trouble? What should I do? I dont own the house anymore but my personal belongings apparently still are contaminated.

  865. November 4th, 2011 at 1:56 pm #Mike Wahl

    I live in NYS. My question pertains to the ACV of a structure. In NYS carriers use “broad evidence” to determine the ACV. As of late they are using the appraised valve of the home prior to the loss. The problem I find with this is being in a depressed economy they, come in with very low ACVs. Any suggestions.

  866. November 4th, 2011 at 2:12 pm #Jason

    Judith,
    Just by you posting the question on here, you know it may be a gray area. I wish there was a clear-cut answer to provide. Your personal property cleaning and/or damage is probably mixed with cleaning and/or damage to the dwelling.

    If the check was issued properly, then it would be drafted to your mortgage company and you. The way you describe the check, it seems the insurance company wrote the check only to you . At this point the check is not worth anything so the check needs to be cashed so funds can be drawn out of the insurance company’s bank. Are you able to cash a legally binding check? Yes you are.

    You have a contract with your insurance company in the form of an insurance policy. You also have separate contract with your mortgage company in the form of a loan and mortgage. There is a little bit of overlap in that the insurance company also has an obligation to protect the interests of the mortgage company by including their name on the check so the mortgage company and you can work out things concerning damage, collateral, and in this case, entitlement.

    Once the check is cashed and you have the proceeds, you will then have to figure out what should be yours and what should the mortgage company’s. For this, you may want to consult with an attorney.

  867. November 4th, 2011 at 2:23 pm #Jason

    ACV is the “actual” cash value. It can and does fluctuate with the economy. An appraised ACV value is one component of the broad evidence rule. The broad evidence rule simply means they look at many different valuation measures to arrive at the ACV. Looking at the appraised value is just one component to arrive at the ACV and more valuations could be used if appropriate.

    I would assume you are looking for suggestions about other ways to value a property. Recent past sales of the home or recent sales of comparable homes are a couple of ways.

  868. November 5th, 2011 at 6:11 am #mari

    i AM ABOUT TO RECEIVE replacement value my question is

    after receiving replacement value money. i will go to store and purchase items lost. If i decide to return items can i keep the cash? what are the fine print?
    is it legal?
    I do not want cash value it dont pay enough , CAN I GET A ANSWER PLEASE SENT TO MY EMAIL ALSO WOULD BE APPRECIATED

  869. November 5th, 2011 at 6:28 am #Jason

    mari,
    What you are indicating is illegal. There has been case law that supports that you should not do that. Do people still do it? Yes, they do. What you do is entirely up to you.

    There is no fine print, it’s based on the principal of what the contract is intended to do. You pay more in your premium to get the amount of value over ACV which is replacement.

    Just replace your damaged items. If you don’t want the items, then it’s apparent that their value is not very much.

  870. November 5th, 2011 at 1:21 pm #Mike

    I live in Northern New Jersey. My homeowners insurance is with Travelers. We never had a claim since we purchased our home in 2001, until this year.

    On Aug 29, we were affected by Hurricane Irene. This was declared a disaster area by President Obama. The power was off for 4 days, many large tree limbs fell onto the driveway, one tree is at a 45% angle OVER the driveway. A lot of flooding, ground water and underground water washed away the front slope of my property, driveway, belgium bloc and mold has started to grow in the shed from water entering it. The shed is a structure covered on my policy. Travelers gave me a $100 check for food spoilage after a $100 deductible and then closed the file.

    On October 29, we experienced a noreaster snow storm that dropped 16 inches of snow. This was declared a disaster by Governor Christie. The power was off for 5 days. LARGE limbs fell onto the driveway and blocked our exit. My pump in my koi pond short circuited, 7 koi fish died, my electrical panel’s MAIN breaker is “frozen” in the ON position, have about $500 in spoiled food, had to stay in a hotel for 1 night and buy food at a diner, fast food & restaurant to eat. Because we have well water, electric baseboard heat, electric hot water, we could not stay in the home. It was about 45 degrees in the home. We could not take a shower, flush the toilets or wash our hands in the home. Sanitation became a major concern. I have opened a claim with Travelers and know they will be very aggressive in trying to minimize the claim. Obviously insurance is a business and they are trying to maximize profit with limiting risk. Any direction with this will be helpful.

    Should I hire a “Public Adjuster” for help? I also questioned the claim rep about my premium and insurability with having 2 claims in 2 months. She did admit that there will probably be an underwriting review after the claim is closed.

    Any help and direction is appreciated.

    Thanks,
    Mike

  871. November 5th, 2011 at 6:01 pm #Dave

    You’re situation is typical. I am a Public Adjuster and I recommend you contact me to get the help you need.

  872. November 5th, 2011 at 8:41 pm #Jason

    Mike,
    As Dave indicated, you could contact him (no contact information to do that) and see if he can help you.

    You’ve indicated that you had some food spoilage, some fish die, additional living expenses, and some extra food expenses.

    First, we all have to eat so if your food cost you $70 instead of $30, your loss was $40 in this example. You still are paying for your house so any extra housing costs are extra expense (or your loss), the food spoilage is pretty easy to figure out. Trees damaged by wind (unless specific criteria are met) are not covered if wind causes the damage. Fish and pets are not insured under your policy.

    I don’t necessarily suggest you contact a public adjuster but you will have to decide what is best for you.

  873. November 6th, 2011 at 2:57 am #Mike

    Hi Dave,

    Tree damage is from the snow. The heavy wet snow so early in the season destroyed the trees and other landscaping. The landscaping is expensive to replace, would this be covered? Also the pond and fish are part of the landscaping, would this be covered?

    Thanks,
    Mike

  874. November 6th, 2011 at 6:50 am #Jason

    Mike,
    Trees are covered for only a handful of causes of damage that include lightning and vehicle (for example). Snow, wind, and rain are not included in those covered causes. -This can be found in your policy.

    Landscaping, regardless of it’s expense, is not covered for damage from heavy wet snow.

    Public adjusters may be appropriate to consider if the insurance company is not being fair with you concerning the value/amount of covered damage that you endured. When there a lot of uncovered damage and you can handle the rest of claim by yourself without concern, then hiring additional help you don’t need doesn’t make sense.

  875. November 6th, 2011 at 6:48 pm #Kathie Godbolt

    My house burned up last year. My adjuster did not and would not tell me how much money I had to actually fix my house. I feel like I was actually coerced into using a State Farm contractor because she kept telling me how I would run out of money and be stuck. Well, the State Farm contractor was a real mistake from the start. No protocall was followed from the start. The next day after the fire I was set up to meet 4 people at the same time, fire chief, restoration people, and 2 contractors. Nobody is in the right frame of mind and they do this to keep you even more confused. You are not able to make rational decisions. If they had been upfront, things would not have been so confusing. Now they are playing the buy it and I’ll give you half until you replace it..Dont they have to pay me fo rwhat my policy states? I thought it was the same as a

  876. November 6th, 2011 at 7:17 pm #Jason

    Kathie,
    A policy pays AVC initially. If you have a replacement policy, when you replace the items, the insurance company will pay you the rest of the funds above the ACV originally paid, and up to the full cost of the replaced item.

    This same principal applies to building parts like the roof and siding as well as a couch, tv, or lawn mower.

    Please post questions if you have them and we will address them as soon as we are able to.

    You may need to bring in someone to assist you with this process that is able to deal with the demands of getting the restoration completed.

  877. November 7th, 2011 at 5:40 am #Maureen

    I recently had a kitchen fire in my house. I have been told I’ll need to replace my kitchen. My policy provides for replacement cost value not actual cost value. The adjuster provided me with a copy of the statement of loss. There are estimates on the report that I believe are under valued. I have proof I paid more for the items than he stated on his report. In addition, he has provided for the detaching of my granite counter top and re-attaching to new cabinets. I have explained to him that the countertop was custom cut to fit the current cabinets that were damaged in the fire. Further, I’m not sure the counter top can be detached without being broken. He advised that my contractor should attempt to detach the countertop and if it breaks let him know. My contractor has already advised me that he cannot reuse the old countertop when he installs replacement cabinets. The adjuster is telling me that I should accept the check from the insuance company so that I can begin to replace my damaged kitchen. I am reluctant to endorse the insurance check because I’m afarid that to do so will prohibit me from seeking additional funds for items not covered or under valued on the statement of loss. What should I do?

  878. November 7th, 2011 at 7:16 am #Jason

    Maureen,
    Discuss these concerns with your adjuster. If you have proof that you paid more than the allowances provided, provide that proof.

    Counter tops can be attached without being broken. Counter tops can be re-attached without being broken. This should not be a concern of yours. If the counter tops become broken while being detached and reset, do you think the insurance company is going to leave the broken counter tops in your home? If your contractor is not able to detach and reset granite counter tops, then you may want to check if he’s a qualified contractor to do this work for you. If he is telling you of his lack of ability to do something, that should be a red flag to you.

    To clarify, your policy provides ACV and when you get the repairs completed, then you can make a supplement claim to recover the difference between the ACV and the replacement cost.

  879. November 7th, 2011 at 7:33 am #Maureen

    Thanks for answering my questions. To clarify, my contrator’s concern was that the current countertop was custom cut to fit my current cabinets. Unless I buy cabinets that the exact same dimension, the countertop may not fit. If by chance the countertop breaks while being detached I did not want to be in a situation where the adjuster is telling me that the contractor is liable for replacing the countertop since he broke it. I paid $3,200 for the countertop and the adjuster has allowed $336.00 to detach and reset the granite. I also wanted to make sure that by endorsing the insurance check I wasn’t agreeing that it reflected full settlement of my claim.

  880. November 7th, 2011 at 8:34 am #Jason

    Maureen,
    Contractors that install cabinets and counter tops commonly use shims. It is very likely shims were used to install your current counter top. You don’t see the shims because they are not meant to be seen; they are only meant to perform a function.

    If the contractor is not able to carefully detach and reset the counter top, then you should look for a contractor that is qualified to complete this task without breaking the granite.

    If the counter top breaks, the contractor should be liable if he broke it. Granite will not break on it’s own. Your counter top has been mined, worked, handled, shipped, and installed without breaking. It would require being dropped or hit fairly hard with an object to break. Absent dropping it or hitting it with another object, the granite should not break.

    If the granite sustains damage during this process, the insurance company would have to become involved in what needs to be done next. Did you confirm your contractor is licensed and has professional liability insurance?

    You are likely being asked to sign either a sworn statement in proof of loss or a statement of loss, or maybe both. These documents lay out the cost to repair your kitchen on an ACV and replacement basis and amounts to your formal claim. If you don’t agree with the allowances provided, discuss that with your adjuster. You need to be able to sign the document(s) with the assurance that your kitchen will be restored to it’s condition before the fire.

  881. November 7th, 2011 at 8:04 pm #Rachel

    hello,

    i currently live in condo and my property walls and floors were damaged by a tree root and after two years my HOA finally open an insurance claim. While my claim is consider a third party liability claim. The adjuster with traveler is using an estimate that i got back a year ago for my hoa to kind get an idea of what the damage will cost. The insurance sent out their own contractor and i never got an estimate telling ME what The estimate the cost of damage is, when i asked the adjuster what his contractor estimate was, he said that it was confidential and couldn’t tell me. He wants to settle but i didn’t agree because i only got one estimate and that one contractor that came out isn;t one that i want to hire to do the work. i told him no, that i;m going to contact another contractor to give me an estimate, because i really don’t know if that will be the total price of repair and that i don’t want to end up paying out of pocket. oH, another thing i asked was, if they were going to pay for my loss of use, because according to the contractor that came out, he said that i couldn’t live in my home for over a month. The adjuster relpyed with its all include in your SETTLEMENT. i had a contractor come out and he said he didn’t feel comfortable giving me an estimate with out an artchiture engineer. i notify the adjuster and again he said it all include in my settlement offer. I was able to receive a copy of the estimate from the contractor he sent out to do an estimate and it turns out that he was charging 25,000 more,. need some help! ca

  882. November 7th, 2011 at 9:12 pm #Jason

    Rachel,
    Can you be specific? Do you have a question? We cannot address an open-ended situation and provide information.

  883. November 8th, 2011 at 9:14 am #RACHEL

    does my loss of use consider as part of settlement when its a third party liability, if not do i figure out how much it will cost me to rent a hotel, food and traveling expenses or does the insurance.

  884. November 8th, 2011 at 9:45 am #Jason

    Rachel,
    If we understand your question correctly, you want to know about additional expense reimbursement or loss of use of your home.

    Simply ask the insurance company how they want to address that.

  885. November 8th, 2011 at 11:48 am #Fran

    In one corner of our garage the foundation is settling. However, the settling is being caused by the downspout leaking underground in this corner of the garage. The downspout goes underground at this corner and joins a pipe that takes it to the street.

    My question is this….should my insurance company pay for this repair. ($3600) to jack up that corner of the garage.

    My insurance doesn’t cover settlement. The house is 26 years old. I really think it may be past it “settlement” phase.

  886. November 8th, 2011 at 1:21 pm #Jason

    Fran,
    No, this very likely would not be covered by your policy. The exclusion for settling is not just for new home settling but for any and all settling.

  887. November 9th, 2011 at 1:11 pm #Teresa

    I have had the same Homeowners Insurance Policy for 20 years and have never been late of never filed a claim. Last week a pipe broke inside the wall and leaked out all into the walls and pretty much wrecked the entire house’s flooring and walls. We decided on Vinyl Flooring but the old stuff had to be scraped up and cleaned off first. The contractor said the wall mounted Flat screen TV was fine and they would even cover it with plastic before they began. The workers were scraping up old tiles making a giant dust storm and they never covered the TV at all. I asked them to stop working until the TV was covered properly and they did but 3 days later when it was uncovered, there is a 1/2 inch gash in the screen. Flooring people took responsibility and we are suppose to be given a new T.V..

    My question is….”Does the insurance company have the right to take my old TV I bought and paid for away from me just because they are righting a wrong they did and giving me a new TV.??? I have an emotional attachment to my old TV because of who gave it to me and I don’t want to give up on it. Please help me What do I do???

  888. November 9th, 2011 at 1:12 pm #Sarah

    We recently had damage to our home due to wind storm. Just a little info…due to recent storms earlier in the year all local roofing contractors are well booked into the spring. Repairing on worse comes first bases…back to my story. Our insurance company came out with their own adjuster and took pics and sent us a check for repairs little over 8000.00..then they came back out about 30 days later and the roof handt been repaird.. now they have started a fraud investgiation on us. We told them all the other repairs had been done. The fraud investigator wants to meet with both of us but every time we give him a date he cant make it for what ever reason. Says he wants to have a recorded statement from us. The Claim was done in Sept and check issued in october..now it will be december before he can work us into HIS schedule. My husband is a truck driver and its not easy finding time to be available at the drop of a hat..which we have told this guy but he insist. We have since started repairing the roof ourselves. I ahve sent before and after pics during the stages of repair. I have reciets for the roofing material but i did not keep any for the paint and intiror stuff we purchased but it is obivious of what was repaired. Can they get us for fraud? Make us repay or put us in jail? I mean we have tried to corporate with them but life just doesnt revolve their schedules. What should we do? I asked him if he wanted me to send the roofing reciets nad pics he said no..i also asked if we needed to stop repairs till he got out there and could see the old roof and he said no..so if we cover up old roof hows he gonna judge anything??
    BTW all i reported was a few loose shingles, water damage on kitchen ceiling and laundry room celiling as well as damage to my front storm door.

  889. November 9th, 2011 at 2:00 pm #Jason

    Theresa,
    If you want to keep the old tv, you can. But then you will forego getting a new television. This choice is entirely yours. If you want a damaged tv, you can have it or you can have one that’s not damaged.

  890. November 9th, 2011 at 2:24 pm #Jason

    Sarah,
    I don’t understand why you are being investigated for fraud. You seemed to skip that part. The answers to your questions are, can you be found to have committed fraud? Yes, you can.

    The insurance company, at this point, appears to be investigating fraud concerning a civil agreement and misrepresentation, etc. concerning your contractual agreement with the insurance company and yourself. It may be a monetary resolution, a criminal resolution, or both. We don’t have enough information to comment any further.

    You ask what you should do. I don’t know. Set up an appointment with the investigator and provide the information they ask for.

  891. November 9th, 2011 at 11:38 pm #Lindsey

    I have a home fire loss insurance claim in CA and the insurance company has issued the claim checks and it is with the public adjuster. Insurance company has asked me to hire any licensed contractor and pull permits. The public adjuster is telling me that he cannot give me the check unless the contractor is finalised and the check has to be deposited with the mortgage company. Yes, I still have a mortgage and therefore I guess the check might even bear the mortgage company name. My public adjuster is trying hard to get this reconstruction project into his contractors hands. My question, is can he insist or even require me to reveal to him the name of the contractor I am considering for this project? If I write a personal check for the public adjusters commission amount won’t he have to release the checks to me or is there any clause by which he can hold onto the check. Then it is between me, my contractor and the mortgage company. Does the insurance company need to see the contract I am signing with the contractor(of my choice)? If this contract amount is less than the insurance payout, can they revoke the check or reduce the payment? If I am able to complete the reconstruction and there is money left over won’t the mortgage company hand over the remainder of money to me. Is there any contingencies the public adjuster or the mortgage company or the insurance company can place on me to deprive me of this money? Thanks for your advise.

  892. November 10th, 2011 at 6:56 am #Jason

    Lindsey,
    You may need someone in your corner to protect you from the public adjuster, but that is just a gut reaction. The agreement between your public adjuster and you can be contracted any way you set it up and asking us questions about that specific arrangement is not something we can answer. I won’t address any questions you presented that concern the public adjuster.

    First, you can hire any contractor you want. If you receive pressure from anyone to hire someone they know, you should resist that at all costs. See my very first sentence.

    Sometimes your insurance company may need to see an estimate. What they generally want to confirm is that the work has been completed so they can reimburse you based on replacement cost.

    Technically the insurance company could reduce the payment for the specific item and/or process that cost less to do they they originally estimated but that doesn’t happen very often.

    If there are remaining funds, the mortgage company has no reason to hold the funds and should release them to you. The mortgage company simply wants to make sure their collateral for the loan has been repaired so it’s value does not remain reduced.

    I don’t know what you mean when you ask about “contingencies”.

  893. November 10th, 2011 at 12:54 pm #roof claim blues

    Hi,
    I have a question on a roofing claim. We had a hail storm in the spring, and most of my neighborhood had new roofs done from the damage. We filed our claim, had our inspection done and an estimate was given for $6900, which included about $700 for gutters and downspouts ($6,200 was for the roof). The roofing company we worked with told us they would charge $6,200 for the roof, and after our $1,000 deductible we would owe about $300 to them (6,200 – 5,900), because the money for work on the gutters etc could be used toward our deductible.

    We proceeded with the work, and a few weeks later received our depreciation check, which was reduced from the original amount to make the total we received from our insurer $5,200 ($6,200 our $1,000 deductible), instead of $5,900. Since the job cost $6200 it’s all our insurer released. I did not put two-and-two together until a few days ago that our final payment was reduced and wouldn’t cover as much as we thought. Our roofer is asking for the additional $1000 now, which we do owe them. But I was angry because they said we would only have to pay $300. They led us to believe our insurer would give us the entire amount of the estimate (I know better now, they can’t speak for my insurer!). Now they say they will try to get our insurer to give me the rest of the money, but I’m not optimistic.

    I’m not sure who to be upset with, my roofer, my insurer, or just myself! I’ve gone back-and-forth on it and have boiled it down to the following questions I need some help on:

    1. Did my roofer attempt to commit insurance fraud with me by telling me I could take ACV money for my gutters and downspouts and apply toward my deductible? (This isn’t the same as them “paying” our deductible by overstating their invoice, but is in a sense the same idea)

    2. If my insurer had given the full $5,900 to me, would I be committing fraud by paying money to my roofer that was supposed to go to gutters and downspouts? (or in a different scenario just pocketing it without making any repairs). Or, are they just being tight about my claim payment, and that money should be mine whether I get repairs done or not?

    3. Is there a legitimate way I can claim the rest of the money in my estimate? Do I have any chance with my insurer on this? My roofer is already trying to contact them, but I know the money still goes through me.

    Thanks for the help!

  894. November 10th, 2011 at 5:55 pm #Jason

    Roof,
    1. Your roofer didn’t commit fraud. He replaced your roof for you and you owe him what he charged.

    2. If you used your gutters and downspout ACV money for your roof, that is fine but then if you don’t replace your gutters and downspouts, you give up the depreciation funds that were withheld for that aspect of the damage.

    3. If you replace your gutters, you can claim recoverable depreciation for that part of your claim. In the end, you will endure your $1000 deductible. The insurance only pays when you have incurred your deductible and they pay the damages above that.

    Please be aware that you generally have 180 days from the occurrence date to make the repairs and make any claims for recoverable depreciation.

  895. November 11th, 2011 at 8:16 am #LeeAnn

    HELP! We went through a major wind and hail storm 3 months ago. We are still fighting the insurance company (AllState). We rent, so our insurance covers only our contents and cars. Our cars have been settled. Each car had a different claim number and was handled by a different person. So 2 cars, 2 adjusters. Both were from Colorado and we live in Kansas. The contents adjusters were from Texas, Virginia and now our most recent one is from Alabama. No one from All State has ever been to our home, what use to be our home. It was so severely damaged in the storm that the owner does not plan to repair or rebuild. We have paid the extra for replacement insurance for 15 years now. Yet they say they will only give us the deprecated value until we can prove with recites that we have replaced the items. I don’t understand! What is replacement insurance?? We are now on our 3rd contents adjuster. I am getting so frustrated. They have told us our beds and sofa are fine just vacuum off the glass and use them when they dry out. On the electronics they told us to plug them in and try them, if they come on they are fine. I explained that when you picked them up water runs out of them. They again said plug them in, if they come on they are fine. His tools which are in the garage that no longer has a roof at all, they say they are a little rusted but are fine. We had a Basset corner sectional which has a replacement value of $6,000. They refuse to pay a replacement value even if we prove replacement. What is the rules on replacement cost insurance?

  896. November 11th, 2011 at 2:23 pm #Sceptical

    After a strong storm, I noticed some water infiltration in my ground-floor condo. My condo insurance wouldn’t cover it, so I placed a claim with my personal insurance. They will cover it, and will refinish the floors in the entire condo (it’s all natural hardwood of the same type) EXCEPT one bedroom. They say that this is because the “wood laths run parallel to the door in this room”. WHAT? According to the adjuster, this “isn’t covered in my policy”. When I told the adjuster that I could not understand the jargon of my policy, and he could not adequately explain, I told him to send a copy to my lawyer. He FLIPPED OUT and yelled at me and told me that he was “from the insurance company and would not try to screw me because they were on my side”. He said that I was “not smart” to consult a lawyer and that if I wanted to “do things the hard way” that he would “not help me anymore”. I tried my best to play innocent and be polite – of course I sent everything to my lawyer anyways – and regain his trust, but he is being a HUGE jerk. Are adjusters paid on commission? Do they get extra to screw people out of what they deserve and have paid for? How should I proceed? Should I ask to be transferred to a new adjuster? Or would that make the situation worse since I’ve become a “problem client”? I would appreciate any advice! Thanks!

  897. November 11th, 2011 at 3:50 pm #Jason

    Sceptic,
    Your policy covers direct damage. Of course the insurance is going to replace the flooring that was affected and the non-affected flooring around the water damaged flooring because you can’t just repair limited pieces of a floor, it basically has to all be done – except- where there is an appropriate stopping place to end the replacement.

    A simple example that should be very illustrative is if a person sets a hot pan on their counter by the sink and burns the counter. To repair it, you can’t just cut out the round burn spot in the counter and replace that small piece. Rather, you have to replace all the contiguous counter top. Now, the homeowner decides instead of the orange counter top, they are going to replace it with a nice looking green counter top. Well, this example also includes counter top on an island in that same kitchen that was not damage by the hot pan. This island counter top will not be considered for replacement by the insurance policy. Replacing the island would be at the expense of the homeowner if the homeowner wanted that island counter top changed.

    In this case, your bedroom doorway is basically an ideal cut off point. Let’s put this into perspective. Let’s say there was no insurance money to replace the flooring and you had to pay for it all. If you could reduce the cost of not replacing the bedroom flooring because it’s a good ending point (and it’s not damaged), then that makes perfect sense and you would do that to save yourself some money. That is what the adjuster is doing.

    Regarding attorneys, different expectations, and the heated argument you to got into, I have no comment for that because I wasn’t there and I only have your side and not that of the adjuster.

    Adjusters are not paid on commission. They likely are paid a salary and they cannot spend insurance funds carelessly. They are held accountable for spending the claim funds in an appropriate manner. All repair decisions may be reviewed by management or during an internal or independent audit. If something doesn’t make sense, he may be asked to support why he replaced undamaged flooring that should not have been replaced. It’s a bit of accountability to make sure things are being done correctly.

    If you want to have a new adjuster, you may request that. If the only concern is the issue regarding undamaged bedroom flooring and everything else is in order, it may be overboard getting an attorney involved. Attorneys are somewhat expensive.

    You probably aren’t a problem insured because not everybody agrees with every single detail that other people may agree with. You have priorities that differ from the priorities of other people.

  898. November 11th, 2011 at 4:11 pm #Jason

    LeeAnn,
    Replacement insurance provides you the opportunity to replace the items you were already paid ACV for and then request reimbursement by your policy for the additional funds you had to pay above the ACV allowance you were already paid. The steps to recover the replacement value are pretty clear.

    We don’t know the extent of any of the damage to your personal property. It’s impossible to provide specific advice on your electrical items or your furniture. Items have to be damaged for insurance to address those items. Items can be dried or cleaned and they may not be damaged. Again, I state, we don’t know all the details to provide any further information.

  899. November 11th, 2011 at 7:07 pm #Erica

    I currently have home insurance with Farmers I recently had a break in August of this year my adjuster ask me for receipts or manuals but i only could provide a few because my claim was large so they had me to do a proof of loss form and have it notarized and also a release for a credit and background check, after i did that Farmers switch my adjuster to one in CA and im currenty in Alabama and my investagator is in Tenn I spoke with the investgator and he wanted to talk to my friends who were with me the night of the burglary which they did speak with the investagator after that I had to do a EUO.. I told them i had filed chapter 13 last year cause i was being sued for being a co signer on a car and the attorney was concern about the contents i listed for chapter 13 which was i hardly listed anything cause i was just tryin to stop the garnishment ..later my transcript came and i signed that everything was acurate the attroney told me they may have to do a follow up he will keep me in the loop..I recently received a call from another investigator wanting to meet with the persons that was with me on the night of the burglary and they meet with the investagators my question is are they trying to deny my claim for that chapter 13 and why they wanting to meet with the persons who were with me instead of a interview over the phone like the first time they spoke with them. i talked to my claim adjuster she stated that we are very close to closing my claim if the persons come in quickly so they can rap it up.

  900. November 11th, 2011 at 7:59 pm #Jason

    Erica,
    It’s not that you filed bankruptcy, it’s what you reported in that bankruptcy that matters. It’s all about if your claim is legitimate or not. I can’t tell you if it is or isn’t. That is why you are doing affidavits, EUO, and they are interviewing your friends. You have to understand that not all burglaries are burglaries.

  901. November 11th, 2011 at 8:29 pm #Erica

    so you are sayin that Farmers is trying to say that my home was not burglarized thats why their doing this investigation on me? I didnt put really anything down on my chapter 13 because it was my computers and x box and etc i didnt know i had to put those things in my chapter 13 the next question is can farmers deny my claim for not puttin all of my electronics on the list for chapter 13 all though they are firmly investgating my claim and im fully coroperating with them?

  902. November 11th, 2011 at 8:54 pm #Jason

    Erica,
    No, I’m not saying that. If you wanna see what I said, please re-read my last post.

    The items that you put on your chapter 13 are supposed to be every single asset that you own. If you don’t include all the items you own and they magically appear on a notarized document just a short time later, that raises suspicion that 1. You don’t own the items you are claiming or 2. You have misrepresented (lied) in one or both of the documents that you swore are truthful. It’s a double edged sword. If there are items of any concern that are not listed, it makes the entire situation very awkward for you. I’m sure I don’t have to tell you that.

    It doesn’t matter if you knew you were supposed to put those on your bankruptcy or not. You are supposed to and not knowing you were supposed to list something is not an acceptable excuse.

    Can farmer’s deny your claim? Yes, they can. They are in a very good position to do that based on the information you provided. If they deny your claim and you happen to sue them for denying your claim, they will bring the court’s focus to the errors in your documents and they will be in a position to persuade the judge that some documents that you have prepared (bankruptcy list and claim forms) may not be entirely accurate. They will use this cloud concerning your credibility as long as they can.

  903. November 11th, 2011 at 9:02 pm #Erica

    thanks jason

  904. November 13th, 2011 at 6:54 am #Cheryl

    I live in PA and I had a house fire in Aug 2011 and the insurance company still has not settled my claim. We do not know how the fire stated so we had to sit through a deposition that lasted about 8 hours, it felt more like an interrogation. They even called my husbands 80 year old grandparents and interrogated them and asked them if they would hire someone to burn our house. ( The fire started upstairs in a storage area which was also the roof of the front porch). The insurance company had two investigators, and did not even approve the claim until February of 2011, so the house sat all winter and more damage was caused due to it sitting. The adjustor still does not have the dry wall, insulation, front porch and a lot of other things in any of the estimates ( we have 10). The adjustor we had just retired and now the adjustor for my personal property is also taking over the dwelling who stated she does not have experience in dwelling claims. in the last year we had only heard from the adjustor 3 times and that includes the first meeting with him after the fire, the other 2 times was by phone and we had to call his boss to get him to call us back the last time. At this point what options do we have? I just want to be back in my home.

  905. November 13th, 2011 at 7:02 am #Jason

    Cheryl,
    We don’t understand. You had a fire in August of 2011 and your claim was approved February 2011? I will assume your claim investigation is not approved as covered yet. The insurance company is attempting to determine how the fire started. They appear to have a suspicion that it could be arson and they have to either rule that out or confirm it.

    It’s been about 2 months since the fire. At this point, you have to let the insurance company determine if there is coverage for the fire or not and you will have to wait. I don’t know if you have any other options.

    Who is your insurance company?

  906. November 13th, 2011 at 8:15 am #Cheryl

    Sorry the house fire was Aug 2010

  907. November 13th, 2011 at 11:19 am #Jason

    Cheryl,
    Your house fire was in August of 2011 and your claim was approved in February 2011. I assume that then to mean that your claim was investigated and the insurance company accepted the liability of the damage and repairs are being made or have been completed. What kind of options are you looking for? We don’t have enough information to provide you options because we have no idea what’s going on other than you had a fire, the insurance company thoroughly investigated the fire, and you apparently are not yet back in your house.

  908. November 13th, 2011 at 4:46 pm #Cheryl

    The house fire was Aug 2010 and the insurance company still does not have all the work that needs done approved. All the dry wall in the house was damaged either by the fire, smoke or water. The same with the insulation and the insurance company is saying that they are not paying for it. They also are saying they are not going to pay for the front porch, they said it was damaged prior to the fire. The fire started over the front porch so all the items that were stored above it was on fire and ended up on the porch along with the gallons of water. What options do I have to get the insurance company to get my claim moving and get me back home

  909. November 13th, 2011 at 5:01 pm #justme222

    Cheryl,

    You can either try to deal with your insurance adjuster and get them to cooperate or you can hire a public adjuster. Note: you should also send your insurance adjuster e-mails as much as possible, because they will claim that you never tried to contact them.

  910. November 13th, 2011 at 5:27 pm #Jason

    Cheryl,
    It is true that the squeaky wheel gets the grease. Call the insurance company. Talk to the claim supervisor. Make sure they know you are not content with the speed and lack of attention to the items that are damaged. And don’t just call one day and stop. Your calls should be frequent until you see the progress you want with your claim. If there are items that should be covered by your policy, ask that the adjuster come out again to specifically identify what should be repaired, replaced, or not addressed by your policy. This is another example of being the squeaky wheel.

    Was the front porch damaged by fire prior to this fire? Was the front porch damage by some other peril and not repaired when this fire occurred? We simply don’t have enough information to address that part of you claim concerns. I am not convinced your claim requires the assistance and expense of a pubic adjuster.

  911. November 14th, 2011 at 1:43 pm #Tamara

    I recently had an issue where my basement flooded. The basement is occupied by my sister in law. I intially filed a claim including her possession (clothes and personal articles). The insurance company told me that they would not cover he items as she was not listed on the policy. I resubmitted the claim for my furniture and some articles I had stored in the basement. The insurance company is now insisting I supply photos of the items with me in the photos. Can they demand this?

  912. November 14th, 2011 at 4:43 pm #justme222

    Cheryl,

    I’m not convinced you need a public adjuster either, but I gave you what you asked for: OPTIONS

    Tamara,

    They can ask you for photos if they want. The problem for them is if you can’t provide them, then that’s just too bad. They would have to actually prove you are lying about the contents. If they cannot do that then I would guess that they are gonna pay after a while because they have too much to loose. If they can’t prove you are lying(not saying you are)and deny your claim then google “bad faith insurance lawyers” and hire a lawyer right away. Keep in mind that you may have a deadline to file suit, so read your policy carefully.

  913. November 14th, 2011 at 4:53 pm #Prince Sam

    My condo unit has a water damge from upstairs apartment. My condo association filed claim to the condo insurance and they paid only part of the money. While association was in discussion with insurance, I went ahead and filed claim against my own home owner’s insurence. At last my insurance paid most of the money. and in between condo association was able to get the remaining amount from condo insurance company. Do I need to return either of the money and if yes which one should I?

  914. November 14th, 2011 at 5:07 pm #Jason

    Tamara,
    It appears they are asking for receipts of the items in your photos. Many people don’t have receipts for items they purchased just a few days ago.

    What the insurance company is doing at this point is making sure there is no overlap of ownership because you presented items in your claim before that didn’t belong to you.

    Somehow you are going to have to provide them the assurance that the things you claim are actually yours so they aren’t paying for someone else’s property. You can probably discuss this with your claim adjuster to determine exactly they want from you so your claim can proceed.

  915. November 14th, 2011 at 5:18 pm #Jason

    Tamara,
    I see another comment indicated your insurance will have to pay if the insurance company can’t prove the items don’t belong to you. In your case, it appears that your insurance company has documentation that supports misrepresentation of your claim since your claim included property not owned by you already. That is likely why they are placing these requirements on you.

    The thing is that your entire claim can be denied because you have presented your sister in law’s property for coverage under your policy. Property not owned by you is not covered by your policy. Misrepresentation in any part of your claim can result in a denial of your entire claim. And, you need to know this because the information provided to you on this site will be as accurate as it can be based on the information you provide to us.

  916. November 14th, 2011 at 5:29 pm #Jason

    Princesam,
    Generally when there is a claim in a condo association, there will be a master policy and individual unit owner policies that become involved in damage that overlaps.

    It is common practice for the insurance companies to coordinate and communicate with the other insurance companies concerning coverage, payments, and who has what obligations for which damage.

    If funds were provided to you, the funds should have been adequate to make the estimated repairs. If all the repairs are completed, then the claims files will be closed. Insurance companies don’t pay extra to have work completed with the anticipation they will have money returned to them. So, if you have remaining funds, it is very likely the insurance company or companies are not looking for any funds to be returned.

  917. November 14th, 2011 at 5:52 pm #Tamara

    Thank you so much for all your replies.
    As far as misrepresentation goes, there is also an issue where the insurance company had informed me that anyone who lived in the house was covered, which they later decided was misinformation.
    As far as the claim goes, since they did not deny the initial claim but informed me that certain items would not be covered and an amended list was then submitted, is that a valid reason for denial?
    Ie, would they not have just denied it rather than say ‘hey xyz is not covered?’
    As for what they want, they are insisting that photos of me with the items is the proof they need….

  918. November 14th, 2011 at 9:32 pm #Jason

    Tamara,
    Perhaps a resident relative would be covered but I have not reviewed that. However, I don’t think a sister in law would be considered a relative as it would be intended or insurance purposes.

    I don’t know how strict they may be when it comes to allowing a correction to the initial claim or if they will stick to a stern denial. That is where it may be appropriate for you to call your adjuster and find out what you can do so you are within the appropriate guidelines for them to accept you claim for coverage review. If they ask for receipts, provide them with as many as you can and then ask for other things you can do to support your claim. You have to build their trust back up so they know they can rely on the things you submit.

    Hopefully, they are giving you another chance to submit it with only your items being claimed. If they want photos of you with the items, by all means, send that to them.

  919. November 15th, 2011 at 11:30 am #Teresa

    I live in PA, I have State Farm Insurance. We had a storm this spring with hail the size of golf balls. I received much runaround from State Farm adjusters. State Farm states I had damage to my siding, gutters, and roof ridge vent (my car also sustained damage). But hey are denying any damage to my roof even though my contractor pointed out the hail damage and there is black streaking which appeared on my roof after the storm. I have contacted the Insurance Commission but received another letter from State Farm which they continue to state there is no damage to my roof. I’m still waiting to hear from the Insurance Commission, but is there any other recourse I can take? I can’t believe my house (and car) suffered such damage from the hail, but the roof miraculously remained unharmed, according to State Farm.

  920. November 16th, 2011 at 9:58 am #Jason

    Teresa,
    Hail does not automatically cause damage to a roof. It can cause damage to components of you home like gutters, siding, etc but the mere presence of hail does not mean it damages the various component of a home.

    You mentioned black streaking. That condition is not the result of hail contact with your roof. I don’t know what that is but it may be algae that has always been there but you didn’t notice it until this hail event.

    It may be correct that your car and parts of your house sustained damage but your roof did not.

    Also, to be direct, the insurance commission will do absolutely nothing for you other than making sure state farm addresses your concerns.

  921. November 17th, 2011 at 7:10 am #Teresa

    Jason, though I do appreciate your response, I feel you did not actually read my post. I did say that my contractor pointed out damage to my roof as a result of the hail – they sent photos to State Farm and were present when the adjuster was at my home.

    As I mentioned in my post, the black streaking was NOT there before the hail storm. I walk up and down my street daily and look at my house and roof. My neighbor also noticed the black streaking on my roof immediately after the storm which he can see through his window. I don’t appreciate you telling me it was there previously, I pay alot of attention to my home.

    I’m not an idiot, I don’t appreciate you responding like I am. I was looking for an answer from you in what recourse I can take. You provided me with no help.

  922. November 17th, 2011 at 7:57 am #justme222

    Teresa,

    I understand your frustration with Jason, but you have to look over him as he is just arrogant and mouthy at times. He provide good answers from time to time when he’s feeling good, but at times he’s just a little insecure with hisself. He has too much pride to just say he don’t know about certain situations. So he make things up to make you look like the stupid one……please forgive him!!!!

    Anyways, I have had plenty of claims where insurance companies have paid for roofs as a result of hail damage. You are taking the correct steps. Also make sure you stay on them but at the same time…be nice and respectful to your adjuster. Hint: If your contractor draw the bid to show the damage they will fix it. He just have to make sure he can back his claims.

  923. November 17th, 2011 at 9:21 am #Jennifer

    Theresa- ask for another adjuster. We had a bad hail storm too and when the first adjuster came out he didn’t look at any of our damaged personal property- and the detached garage that is 30 feet from the Home somehow wasn’t damaged. Our contractor said there was damage but our adjuster kept pushing and denied it- our original adjuster allotted for just about $8000 in damages, and when the second adjuster came out, all of the sudden our payout was close to $20000 including our detached garage. So it pays to ask for supervisors and even a second adjuster. Sometimes during cat claims they outsource the adjusters so you army working with someone who is an actual employee of your insurance company. Good luck!

  924. November 17th, 2011 at 9:30 am #Jason

    Teresa,
    Sometimes there are no reasonable choices of help available. I won’t provide anyone with a response that gives someone false hope. That is about as bad as giving someone the wrong responses to their questions.

    Haag Engineering is the unquestioned leader regarding the subject of hail. This firm was established in Texas about 80 years ago and has a country-wide presence. Haag engineers can determine if a condition on a roof is hail related or not. The determination that Haag will provide is, without a doubt, what anybody will believe concerning hail. Haag will convince any contractor, the insurance company, any judge, or any jury panel panel whether or not the condition on a roof is hail. You may ask why I’ve mentioned this company; I will address that shortly.

    I am going to offer you assistance beyond the exchange we can do on this forum. It’s up to you whether or not you want help from me. I will always be up-front with things and probably be more direct than people are used to. But the biggest tragedy is when people take a course of action not knowing what the end result is when I could easily tell them and save them time, money, and frustration.

    When someone indicates their contractor pointed out hail damage, I am aware most people do not know how to identify hail damage from other conditions on a roof. I’m sorry you are offended by my response that hail will not cause black streaking; that is just being direct.

    There are a number of things you can do. To tell you everything you can attempt would make this post more than triple the length is already is. For now, I will tell you the most certain way to confirm your roof has hail damage. You can hire a Haag Engineer to inspect your roof. They will inspect and report their findings to your insurance company and I can guarantee the insurance company will act on their findings no matter what.

    There are consequences to this option. If their findings conclude hail damage, that confirmation from the premiere hail authority in the world, would guarantee your insurance company will pay for any hail damage Haag has defined. If Haag concludes there is no hail damage to your roof, then you can rest assured there is no hail damage. Because you hired this company, the only thing left to do is pay for the services they provided without any option to be reimbursed. Their charges to you may be more expensive than the cost to replace your roof.

    I’m not entirely convinced this approach is reasonable for you because of the cost to obtain the the services of this company. Here is another option: If you want to send hail damage photos (including close-up photos) of the hail damage to me at complete.insurancehelp@gmail.com , I will review those for you and intervene as appropriate. I will need to know more information as well but I will ask for that information later if you wish to pursue this with any assistance from me.

  925. November 17th, 2011 at 2:19 pm #Ty

    My insurance approved a claim on my house for roof and AC replacement. The storm was in 10/10, I put the claim in 04/11. I am trying to put my AC on now 8 months after the claim, they are saying since 1 year has past from 10/10 they do not have to pay on the claim, how can this be?

  926. November 17th, 2011 at 4:09 pm #Jason

    Ty,
    It’s based on the contract agreement located in your insurance policy.

  927. November 18th, 2011 at 8:59 am #justme222

    Ty,

    In most policies you have a year to replace. I am almost certain that that’s the case with yours. Ufortunately you can’t do anything about it if they don’t wanna grant you more time, but you can ask. Sorry, but that’s just how they do things.

  928. November 18th, 2011 at 7:01 pm #Melinda

    Several months ago we had a severe hail storm in Tennessee that resulted in many property damage claims in the area. Our home had roof and gutter damage that caused a ceiling leak in our bedroom. We filed an insurance claim; however, due to the number of claims in our area, it took several weeks for an adjuster to assess the damage.The insurance company approved the claim and issued a check made out to us & our morgage company (GMAC). The morgage company stated they would release the funds in thirds with the final third released after inspection of the work. The morgage company has had the check for 4 weeks and has yet to release any funds. It is now approaching winter and we must go ahead with the roofing work before the winter weather prohibits it from being done. How long can the morgage company delay releasing the initial third of the money? Do we have any recourse for further damage from leaking ceiling during the delay of receiving funds from morgage company? If the delay in receiving funds from our morgage company continues and the roofers are not able to work due to freezing weather, what can we do?

  929. November 18th, 2011 at 8:12 pm #Jason

    Melinda,
    Please see the situation of Ty immediately above? If you have been paid AVC and there is an amount you can claim after the repairs have been completed, you need to know that.

    You really need to be discussing this with your bank. It’s been about 4 weeks since you should have been released the initial 1/3 of money. Are they waiting for you to submit an accepted contractors estimate? Because the bank is not releasing your funds, it seems to be a bank issue and not insurance an insurance issue.

    If the repair required to the damaged ceiling increases more than what they have already estimated, someone will have to pay for that. The roofers should be working on this job already and you should not be dependent on the bank holding you hostage. This is your home and you need to get it repaired because if you don’t, nobody else is going to.

  930. November 21st, 2011 at 2:57 pm #Deborah

    I have homesite HOMEOWNERS insurance
    HO 04 95 11 92

    I have sump pump coverage of $5,000. My adjuster just allotted us the max which is the $5,000. I just don’t understand , does this amount include my “personal property” too?

    I don’t understand this statement which the adjuster told me to read .

    This endorsement does not increase the limits of
    liability for Coverages A, B, C or D stated in the
    policy Declarations.

  931. November 21st, 2011 at 8:22 pm #Drenched

    Last month a storm dropped 18″ of snow, several trees and 5 days of power outage in NJ. After several days of no electric I walked into 4″ of water in my finished basement. The fairly new toilet was spewing water for ??days?? The water to the toilet is shut off and the adjuster is the only one who examined the toilet. Allstate is denying the claim due to Mechanical breakdown. I’m having a very difficult time accepting their decision. I’ve used the same insurance company for over ten years and have never submitted a claim. Your thoughts???

  932. November 22nd, 2011 at 2:16 am #Jason

    Deborah,
    Yes, that is the total amount for your home and your personal property.

    This endorsement does not increase the limits of liability (insurance company obligation) for Coverages A-home, B-other structures, C-personal property, D-additional living costs.

  933. November 22nd, 2011 at 2:21 am #Jason

    Drenched,
    You indicate the water was not being supplied to the toilets yet water was coming out of them. That would be water backup. If you have water back up and sump pump overflow, you may have limited coverage. Otherwise that condition is excluded in your policy.

  934. November 22nd, 2011 at 9:45 am #Mike

    I had a homeowners claim, I have been living together with the same woman for over 5 years but we are not married. Can her property be covered on the claim?

  935. November 22nd, 2011 at 10:18 am #Jason

    Mike,
    Technically her property is not covered in the policy. This is likely what your policy reads:

    Property of roomers, boarders and other tenants, except property of roomers and boarders related to an “insured”

    If she is not related to you, then that would apply. The only other thing depends how her property because damaged. If it is your fault, like you running the items over accidently with your car, then the following would apply:

    Damage To Property Of Others – 1. We will pay, at replacement cost, up to $1,000 per “occurrence” for “property damage” to property of others caused by an “insured”.

  936. November 22nd, 2011 at 10:26 am #Drenched

    Jason,

    Thanks for your prompt reply – I apologize for being unclear. Water was being supplied to the toilets until I found the one spewing. That’s when I turned off the valve. It’s still off so I have no idea why it overflowed. My focus has been on emptying, tearing out,drying and insurance coverage. This was clean not sewer water in the basement – My neighbor said it may have been a valve. This was not my idea of minor water damage but 1500 sq feet of carpet, three rooms of furniture, and now smelly sheet rock & floor board. The denial letter said Mechanical Breakdown.

  937. November 22nd, 2011 at 10:34 am #Jason

    Drenched,
    To provide an example, if water escaped from your toilet by means of a water supply malfunction, I don’t believe that was the intent of the mechanical breakdown language in the policy. The wording in your policy refers the exclusion concerning mechanical breakdown in the surrounding context:

    (a) Wear and tear, marring, deterioration;
    (b) Mechanical breakdown, latent defect, inherent vice, or any quality in
    property that causes it to damage or destroy itself;
    (c) Smog, rust or other corrosion, or dry rot;

    Mechanical breakdown concerning a toilet would be if the porcelain was old and it crumbled causing it to “breakdown”. The insurance company appears to be using the intent and wording of the policy incorrectly.

    I would need to know exactly what broke down (allegedly) for them to rely on this exclusion.

  938. November 22nd, 2011 at 10:37 am #Jason

    Drenched,
    If you wanted to send me specific details of your claim without posting at all the details on this forum, send it to complete.insurancehelp@gmail.com

  939. November 26th, 2011 at 3:43 am #Desperate

    Jason,

    In 2008 we took in a foster son, Roger, after Child Protective Services removed him from his drug addicted parents. For 4 of the 5 years he was with us, he did well. He was captain of the football and lacrosse teams in our town, had perfect attendance and was an honor role student. However, that all changed overnight when his older brother was released from jail (where he’d been for entire time we had Roger) and he quickly started to decline. Within a few weeks he’d become extremely unmanageable. He lied, stole, refused to follow rules, did whatever he wanted to and when he was punished, he would just runaway. Finally in June, he got caught stealing from his teammates and friends at school. Not just ONE item, but COUNTLESS items – from their backpacks in the locker room. Roger was a popular student, and as their Captain, they trusted him. Once he was caught, it was decided by the parents of the other students that he needed to admit what he’d done to the whole team. Well, he couldn’t do that. He didnt want to ever face his peers again, so he had asked his previous law guardian if he could be placed in a different home. Her answer was no. So he ran away. He was gone for 5 days, and when he finally came home he was totally stoned, and had been with his mother running the streets and decided that was the life he wanted. He made more calls about how he could get out of our home, but he was consistently told he couldn’t. Well, the final straw came on July 11th. At 2am we notified that Roger, was caught looking in the bedroom window of a 13 year old classmate. We had spoken to him countless time about this because he had been stalking her for weeks. We had done our best to control him but there wasnt much left we could do. That day he ran away for the last time and made it clear that he wouldnt be back.

    Just before the July 11th episode, we had been trying to get assistance from ANYONE. Counselors, the state, the county with a PINS petition and various Family Asset teams, however, none of those were able to help. Once he ran away this last time, we were done. We had done everything to help the kid and we knew Roger was with his biological family in the inner city. His mother is a crack addict and a prostitute. We knew that she had been giving him drugs since he was 7, except for when he lived with us. But after he ran away, we learned he had joined their gang (the mother, brother and sister are all members of the same gang), he was carrying a gun, he was back to doing drugs with them and burglarizing people. We decided that we needed to protect ourselves so we gave him about 2 weeks to come to his senses. When that didnt happen, we packed up his belongings, changed the locks and went down to the courthouse to rescind legal custody and request an order of protection. On August 1, 2011 I had that paperwork notarized and brought it to the court house to file it however, We were told that as long as we couldnt find Roger, we couldnt serve him and therefore the court couldnt do anything. We were told we would just have to wait for the police to pick him up. What a joke. They dont look for runaways in this community because “they dont have the resources.”

    Anyway, on Sept 11, 2011, I came home and found that my house was burglarized. There were multiple windows and door kicked in, and the most valuable things we owned were stolen. We knew exactly who did it. First of all, we live way out in the country and our house is surrounded by farms, we also have a rather large dog and no one would’ve come in with him in here, and finally there were things stolen that no one else would’ve known existed. For instance, in a sea of books there was one very rare and valuable book that I hid rare cash in. It was the only book that was touched, and it was missing. We immediately filed a police report and called the insurance company and I explained to the claims rep exactly who I believe burglarized our home. One of the things stolen were my medications. Since I needed those to survive, the homeowner’s insurance cut us a check for that immediately.

    During the time it took me to complete the rest of the claim we located Roger and he was taken into custody. He was placed in an unsecured living facility while the court tried to determine an alternative living arrangement for him since he was no longer welcome here, nor did he wish to come back here. He was charged and admitted to burglarizing our home. However, before the judge can release us from custody, Roger has to be in someone else’s custody. First they tried another foster care home, where he stayed for under 15 minutes then ran away. He was placed back into custody and the judge again tried placing him on house arrest with his aunt. It was to be a 7 day trial period, at the end of which we would be released from custody. He didnt make it 48 hours. He is currently on the run again.

    In the meantime I submitted my claim to the insurance company and we were denied! We received a letter stating that Roger (who is not listed ANYWHERE on our policy) was technically considered an “insured” because he “was in our care.” While technically, yes, we did have legal custody, he did NOT reside with us any longer, and hadnt for over 60 days. But more importantly we did EVERYTHING within our power to protect ourselves from him and be released from legal responsibility for him. The insurance rep also claims that even though we’ve spent the last 6 months going to court to get released from custody, that we are currently still uninsured if HE were to rob us again because he ran away again before the judge could relieve us. I have done everything I can to protect us, but I can’t live in a bubble. I need to have the repairs made to my home, as winter is COLD in upstate NY. We have not been able to replace the windows or doors due to financial reasons. What can I do? How can I fight this? And what can we do to protect ourselves while he’s on the loose?

    Thanks
    Desperate

  940. November 26th, 2011 at 8:34 am #Jason

    Desperate,
    Roger is legally your relative and your insurance policy excludes theft by family members. It is based on the principle that the family is one unit and that is what the policy protects – the family unit. Technically, a family cannot steal from itself because the items remain in the family and for the family’s benefit. Also, the damage to windows and doors is intentional damage by an insured of your policy. That is also excluded.

    So you ask “what can you do and how can you fight this”. There is absolutely nothing you can do. Even if Roger had an accomplice when he did this to your home and property, the entire act is being done at the direction of an insured and still not covered by your policy.

    I have no suggestions for what you can do to protect yourself from him.

  941. November 26th, 2011 at 4:39 pm #Jim Reardon

    I filed a claim for a fire loss ten months ago and my insurance company originally came in and started to dry the house out. After a couple days they pulled the plug and investigated the claim for ten months. The just agreed to pay a couple days ago and want to go in and mitigate damages. I boarded the house up and did what I could to prevent future loss, but didn’t have the resources to do anything else. There was mold from the water from the fire department and sense they waited ten months it’s spread, they also want to test for asbestos in case the there is asbestos where the mold is. My question is that since they waited so long didn’t they drop the ball on mitigating damages. Mitigating damages should be done right away and they didn’t do it. Now that it’s been so long I just want to get paid for the loss and the additional mold clean up. I don’t have a mortgage and I might just buy another property. Since it’s been so long can I request that they just pay the total claim and let me deal with the house? I understand them cleaning the mold and water right after the loss, but now that it’s been 10 months I don’t think a couple weeks will make a difference. Should I be able to request payment and deal with the house myself. I want them out of the equation so I can move on.

  942. November 26th, 2011 at 5:14 pm #Jason

    Jim,
    I don’t know the specifics of what your all your options are. Do you have replacement coverage for the property? You can ask if they will pay the total claim. Unless we know more about your policy, the state in which you live, and other factors, we don’t know what your options are.

  943. November 26th, 2011 at 5:25 pm #Jason

    For more specific insurance claim help, simply e-mail your situation and questions to: complete.insurancehelp@gmail.com We will submit and post your insurance situation and answers on this forum without any identifying information about you. To provide more detailed claim solutions, we may need to ask more specific information from you so provide your e-mail for that purpose. Submit your questions only once.

  944. November 26th, 2011 at 7:50 pm #Jim Reardon

    I live in Syracuse, NY and I have a deluxe policy which covers replacement cost. There are ready to pay and just want to do the mold clean up and test for asbestos. Also, my public adjuster said we have to remove the asbestos if there is any, but I just want them to pay the claim and pay for the additional cost of this removal. I don’t want it to be done now, because I might buy another house or rip this one down and rebuild. I would have let them do this if it was right after the fire, but it’s been 10 months and I just want the claim payment.

  945. November 27th, 2011 at 6:09 am #Jason

    Jim,
    What does your insurance company say when you posed these questions to them? What advice are you receiving from your public adjuster concerning your intentions?

    Out of respect to you, I’m going to refrain from adding anymore confusion to your situation. Right now you have too many people involved in your claim for me to add my guidance. You have yourself, your insurance company, and your public adjuster. To add one more person would be of no benefit to you.

  946. November 27th, 2011 at 9:10 am #Jim Reardon

    Jason,
    I’m just trying to get an outside opinion. My public adjuster is new to the field and seems like he just wants to please everyone. He says we have an obligation to mitigate damages so we have to do these things, but I don’t think he has asked the insurance company if we can just get paid the full claim and deal with everything ourselves. I emailed an attorney I worked with for my EUO to get his opinion, but he hasn’t emailed me back yet. I boarded up the house and did my best to clean up after they pulled the plug, so I did what I could to mitigate damages. The summer dried the house out and now that it’s been 10 months it seems crazy for them to want to pick up like nothing happened. I might sell the property as is and buy another property or tear it down and build new, so I really just want to get paid for the claim and get them out of the picture. I appreaciate any help you can give and I just want an opinion so I have an idea where I stand.

    Thanks

  947. November 27th, 2011 at 9:27 am #Jason

    Jim,
    I won’t do that to you. There are way to many people involved in your claim to add any more opinions, ideas, or strategies. Besides the all the people involved in your claim that I’ve already mentioned, there is also an attorney. Even before I knew that, I mentioned there were too many involved in your claim.

    The simple advice I will render is to eliminate any involvement with your attorney. He has served his purpose with the EUO. He cannot help you any further. Anything to do with that attorney will only complicate your claim and allow him to charge you more billable hours.

    Then, get rid of this unqualified public adjuster. (That likely being impossible because of a contract you have with him.) You have to realize if your intent is to get rid of the insurance company after being paid, that is contrary to the objective of the public adjuster because he wants the insurance company there for every single step of this phase so they can pay for everything, including all the unknowns and those things that can be added later.

  948. November 27th, 2011 at 6:25 pm #justme222

    Jim,

    Yes, you have the right to take the money and buy or build if you want. You must understand that you need to find the property and then they will pay you the full amount. Your adjuster can show you how that’s done. If you just want the money then they will deppreciate. You have to talk to your adjuster about how much. Since your adjuster don’t seem to be giving you all your options you have to deal with him boldly. Tell him what you want and and be direct. Also, the best way to deal with him is e-mail so that you can document all communication and hold him accountable for his actions. Keep your phone conversations limited cause he can always say they never happened…..trust me, they will do it. Further, the insurance company or you adjuster can’t tell you who to hire for your damages, but keep in mind that if you have them pay the claim and buy another property you are still responsible for the cleaning of the mold, etc., and the city will make sure you do it. It has nothing to do with your insurance company.

  949. November 28th, 2011 at 7:49 am #Kathy

    My 15 year old grandson stayed over night at my home. I should mention he is ADHD, forgot his med that morning. It was summer so he was outside while i was doing some work in the house. He came running in to tell me he caught our large barn on fire accidentally trying to make a “potato gun”. It was a total loss. Contents and barn recovery from state farm ins. was around 63,000. My grandson was so upset about the whole thing he spent every day helping clean up. About 2 months latter my daughter received a letter they were being sued for the amount. I am so depressed over the whole situation. What can we do? My husband and I also received a letter stating we should sue for deductions. We live in Pennsylvania. My daughter and her husband don’t own anything but a car. He was wounded in Iraq and just recently found a job.

  950. November 28th, 2011 at 11:22 pm #car insurance

    whoah this blog is excellent i really like studying your posts. Keep up the good paintings! You realize, a lot of individuals are searching around for this info, you could help them greatly.

  951. November 29th, 2011 at 2:59 pm #Jason

    Great forum. I have a question that I am very frustrated about.

    We had a cash value policy on a rental property that was damaged in a tornado. The insurance company issued a partial settlement after 2 months. The reimbursement did not nearly cover the cost of repair, even given depreciation.

    We pursued a more reasonable settlement.

    In the mean time, we sold the property (at a substantial loss). I have continued to pursue settlement with the insurer, which I began prior to the sale.

    Now the insurance company is telling me that I am committing insurance fraud by pursuing a claim on a property I no longer own.

    Is this true?

  952. November 30th, 2011 at 4:14 pm #Minivel

    I made a claim for roof damage. The adjuster estimated my loss to:7,273.08
    with a deductible of 2,200 and less Depreciation of 3,534.. I called them and they said they will send me the 3,534 when the roof is replace and the contractor send them a letter saying it was replaced.. question is Does the contractor have to be certified? My father will be replacing my roof and he is not a contractor are is certified.. And what kind of letter would i send?

    Thank u!

  953. November 30th, 2011 at 4:43 pm #justme222

    Minivel,

    No, he don’t have to be certified, but i suggest you call your adjuster and be up front with him and ask him how he wants you to handle the situation. I’m sure he will work with you on this one.

  954. November 30th, 2011 at 4:44 pm #justme222

    Jason,

    Yes, this is true.

  955. November 30th, 2011 at 4:47 pm #justme222

    Kathy,

    you can’t do anything. I am sure it’s in your policy. ask for a copy of it. whenever a situation like this one happens you must allow them to sue if they want to…..sorry

  956. December 1st, 2011 at 12:50 am #Christina

    Hi there,
    I am hoping that someone will be able to shed some light on a matter related to property owners insurance that has been ongoing for 11 months now. My parents live in a rural area and reside within a property that encompasses approximately 12 acres of land. They have lived here since 1988. As of January 2, 2011, the roof of the barn collapsed due to snow. My mother called the insurance broker to report the incident and was advised that our insurance policy does not cover damage to a barn. She had alleged that my mother had ‘turned’ down coverage on the barn back in August 2010 (when the policy was up for renewal) and had been changed from property homeowners to farm liability insurance, with a 50% increase in her premiums. My mother only answered questions pertaining to the use of the barn (ie. if income is generated from use of the barn, etc). My mother only answered survey questions that were posed to her and proceeded to renew the policy under the assumption that any/all structures would be covered. She did NOT (at any point) turn down coverage. That same day, I took the phone and argued that the terms/conditions of the policy state that ‘detached private structures’ are covered under our current policy and I demanded that we have this claim further investigated . She proceeded to look into the matter further. On January 6, 2011, a claims adjuster came out to the property to assess the damage to the barn and review the circumstances surrounding the occurrence. We were then sent a blank Proof of Loss form (in the mail) several days later. Several months had gone by and we had not heard from the claims adjuster and/or the insurance company. I proceeded to make several inquiries (on separate occasions over a period of 9 months) to inquire about the status of our claim. We were informed on a continual basis that the claim was ‘well passed’ the initial stages and entered the final stage and were advised that this matter would be settled by the end of September. Another month passed and I made an attempt to contact him again and was advised on November 2, 2011 (verbally) that our claim was being denied due to the fact that the barn was originally registered with the township office as a “agricultural building” and its original owners/builder intended to use it as such. We as residents of this property are not commercial farmers and only use the barn as personal storage. We were told that the fact that it is completely irrelevant that we do not use the building for anything agriculture-related. We were informed of this decision in writing from the claims adjuster, as of November 28, 2011 (with only 1 month left to challenge this decision within a 12-month period). This is the primary reason as to why the claim is being denied, coupled with the fact that our insurance broker is “claiming” that my mother did not want coverage (which is a total lie) and is as a result of failure to perform her due diligence when dealing with my mother on this matter. We were not officially informed (in writing) of this exclusion until May 31, 2011 when the renewed policy, for the period August 10/11 to August 10/12, was mailed to us. This was the first time that we were informed of this change to our policy. As of now, we only have one month left to challenge this matter. We feel that we have been dragged through the mud and are at our wits end as to what course of action to take. I don’t know if it is advisable to contact a public adjuster to assist in this matter or if we should proceed with legal action against the insurance company or broker. I realize how limited we are in terms of the deadline (January 2, 2012 – 1 year from date of claim) to proceed any further and if there are grounds to fight this. My parents are both retired people on a fixed income and I personally feel that they are being taken advantage of due to the circumstances and the fact that English is not their first language. Any advice or additional insight would be greatly appreciated. I don’t know what to do to help them at this point…..I do apologize for the length of this question…

  957. December 1st, 2011 at 12:02 pm #Jason

    Christina,
    What it sounds like is the policy insuring your folks property is a homeowner policy. That policy does have coverage for related private structures. It’s likely an HO-03 Homeowner policy. The HO-03 is a very common insurance form used. If they have a policy that is similar to FO-3, then the barn would have to be listed in the declaration page of your policy for it to be covered. The FO-03 is a Farm/Country Home Owners policy.

    One way to extend that 12 month time period is to file a lawsuit against your insurance company. Doing that will extend the amount of time to continue to pursue this. We will need to know more about your parent’s claim that will be too detailed for this forum. If you want to discuss this further, simply send an e-mail to complete.insurancehelp@gmail.com and provide the name and number of the insurance policy (generally found on the bottom of your insurance forms), and the state in which this barn is located.

    That way we can converse with more specifics in the e-mail exchanges. The answer/response will be posted on this site and won’t contain any personal information about you.

  958. December 1st, 2011 at 12:26 pm #Jason

    Jason,
    No, you are not committing fraud. What you are doing is negotiating for more compensation in regard to your damages. You are doing nothing against the law when you disagree with someone about the ACV of your damaged property.

    Insurance fraud occurs when an insurance company, agent, adjuster or consumer commits a deliberate deception in order to obtain an illegitimate gain. It can occur during the process of buying, using, selling or underwriting insurance.

    You are doing nothing deceptive when you do not agree with the ACV of damage. From what you posted, you are not doing anything deceptive and that is apparent because the adjuster is aware you no longer own the property.

  959. December 1st, 2011 at 1:12 pm #Ric del Rosario

    My question is how long does it take for claim adjuster/or the claim examiner to give you a idea of the settlement and can we request a copy.

    we had a water damage in my home. And its been 3 weeks now since the accident and we have’nt heard any information about the settlement. I called the adjuster to follow up the case. And he replied ” i’m to busy with my other case and i need to finish them and then you” is that a right response for them.

    All we need is an idea for us to prepare and to get a quote (contructor) for the repair of the damage.

    thank you very much

  960. December 1st, 2011 at 1:40 pm #Jason

    Ric Del Rosario,
    Sure you can request a copy of the estimate. Your home damage is the subject of the damage in that estimate.

    Sounds like your adjuster is too busy and/or doesn’t have good time management.

    Whether you have the information from the adjuster, you need a contractor and the contractor’s estimate, so get that right now. You have to get that no matter what.

  961. December 1st, 2011 at 5:32 pm #Edward Dent

    I live in NJ and I recently discovered a severe mold problem in my basement (professional tester and lab confirmed it). I filed a claim with my insurance company since I have a specific mold rider. They sent an inspector and they told me that the inspector showed that the mold was initiated by seepage through the basement walls and that seepage was not a peril insured against.
    The mold rider SPECIFICALLY says that mold caused by seepage is covered as a peril insured againt. When I pointed this out I was then told that the TYPE of seepage is not covered because it came from ground water and in the general policy WATER DAMAGE is excluded when it results from seepage due to ground water AND mold is considered water damage
    My position is two fold. First, the specifics around ground water seepage should have also been put into the mold rider if they did not intend to cover that SPECIFIC type of seepage. By specifying a specific cause of seepage in the general section, but not on the rider, implies that all forms of seepage that cause mold are covered (lest it should have been excluded).
    Do you think this makes sense and that I have a good shot at appealing this. The mold remediation costs $5000, but the rebuilding will max out the $10,000 limit. Also, my family has been sick all year and our doctors believe it is due to the mold in the house.

  962. December 1st, 2011 at 7:27 pm #Jason

    Edward,
    Had it not been for the water seepage at or below ground level, there would not be mold in your house. Since the damage from water seepage is excluded in the base policy form, it carries that exclusion forward to you mold coverage form. It is possible some limited coverage exists (for example if mold results because of a fire and the water the fire department uses to extinguish the fire.)

    You can appeal this but you will only be successful if there was a covered cause of loss that caused the mold.

  963. December 1st, 2011 at 7:56 pm #claims solicitors

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  964. December 1st, 2011 at 8:20 pm #justme222

    Ric,

    request the copy of the estimate from your insurance company via e-mail.

  965. December 1st, 2011 at 8:28 pm #justme222

    Ric,

    DO NOT get an estimate from your contractor first. Why: simple, your contractor may give you cheaper estimate than the insurance company’s. why would you show your hand before you have to. keep in mind also that the insurance company may be intending to fix other things that you did not realize they were….but not if you present them with the first estimate. Note: you do not even have to get an estimate from a contractor if he agrees to do the work according to the scope(estimate) that your insurance present which would more than likey be more than what he would have quoted it. joke: then your contractor might share a little bit of the wealth with you….get it!!!!! (free one)

  966. December 1st, 2011 at 8:31 pm #justme222

    Ric,

    I forgot to answer you other question. the time limit varies from adjuster to adjuster and so on. in my opinion you should be like a month before you get things squared away, but that’s just a guess. i may be wrong, it could be a little sooner, but not much later.

  967. December 2nd, 2011 at 7:39 am #Deb

    About 4 years ago we had an addition put on our house, above the main area of a split level home. A few months after the addition was completed, we had water coming in through the walls right into the electrical box in the heater room. The builder came and “sealed” the area around where the wires came into the house which wasn’t the actual source. We found this out more recently when I took table leaf out of the coat closet by the front door and the whole wall is moldy along with the closet contents. Of course I called the insurance (Travelers) and I live in Pennsylvania. While the agent was inspecting the front, I mentioned that the corresponding area in the back of the house, that all is where the old and new sections of the house meet, has water damage too.
    About 2 years ago, we had filed a claim when water was coming in right through the window in the kitchen (back side of the house). The claim adjuster, withdrew the claim at that time because there wasn’t enough damage. The water stopped leaking through the window but then tracked to a different area and has eaten away at the corner wall of the kitchen near an exhaust fan.
    Today he emailed me and is having another inspector come to see if they can determine the cause of the leak that caused the mold in the front closet but the adjuster said that the kitchen area is not included in his claim as it is part of the claim from two years ago that was withdrawn becuase the loss date was from 2 years ago for that part of the house. I don’t understand why that is the case when the damage now was not there 2 years ago. I’m worried that maybe now they will say that the back part of the house isn’t covered since too much time has passed.
    Do I need to go after the builder of the addition, since that was when all this started?

  968. December 2nd, 2011 at 6:20 pm #Jason

    Deb, if the water is coming in at or below ground level, the damage won’t be covered. Perhaps you should have the builder correct these issues.

  969. December 3rd, 2011 at 7:09 am #Ric Del Rosario

    @ justme222 thank you very much for the advice. Yesterday I called my adjuster follow-up the development of the case and asked for a copy. He said the paper was already passed to the examiner and advice to get the copy from them. Called them up. The paper is there but she refuse to give me an estimate. She said, when we send you the check the copy of the adjuster report is there??

    My question again is?
    What happens if the damage settlement is not enough the repair or replace all the damage area?
    When is the right time to settle this issue.
    Can I refuse the sign the check??
    Please advice thank you very much…

  970. December 5th, 2011 at 12:52 pm #Carol

    My daughters house has multiple problems, 2 bathrooms have black mold and leakage from pipes, the walls have to be torn into and replaced, the mold taken out and the pipes replaced. the insurance adjuster did this as 2 claims. which took 2 500.00 deductibles, I thought this wasn’t right. But, when I contacted my adjuster he said yes it is 2 different incidents. the claims were written on the same day.. I explained to him that I had a roof leak and had a bedroom fixed and the roof replaced, that was only on 1 claim, but he went into if you have a car wreck 1 day that is a claim and if you have a car wreck the next day that is a claim. Yes, I understood that…. but this is different. Can someone explain this to me?

  971. December 5th, 2011 at 2:18 pm #Jason

    Carol,
    I’m sorry this guy brought cars into his explanation because cars have nothing to do with your daughters homeowner claims.

    It depends what the source of water is for each claim. If 2 separate areas of your daughters home were damaged from water from a broken pipe, then that would be one claim.

    If there were the same 2 different areas of damage in your daughters home from the broken pipe and there was another area of the home that was damaged from water that leaked from a hole in the roof because of a tree branch that fell and made the hole, then this would be 2 claims and 2 deductibles.

  972. December 6th, 2011 at 8:16 pm #shirvell

    Is there a legal rate/cap that a public adjuster can charge to help with a claim in the state of pennyslvania…Is 20% the going rate for this service?

  973. December 6th, 2011 at 9:35 pm #Adam

    We had a couple severe hail storms roll through northern Illinois over the summer that did some moderate damage to the windows of our home. A property claim company came out and inspected the windows — determining nearly all showed evidence of spattering and/dents. Further, about 8 windows had broken seals. Our insurance provider, Liberty Mutual, sent an adjuster who had no idea about windows who cut us a small check covering a power outage during the storm time (for spoiled food in the fridge) and to cover skylight flashing kits for the 5 damaged skylights (two of which leaked and one had broken seals).

    She then proceeded to say one of their contractors would need to come out as she didn’t think replacement of the windows was warranted. A few weeks later their contractor came out and met with our property claim rep and looked at all windows. He agreed that the majority of the windows had evidence of hail/wind damage and should be replaced. The Liberty Mutual rep said things were approved and were in process of being finalized. A couple months of back and forth went by when the insurance rep said their contractor hadn’t filed some necessary paperwork.

    The property claim rep kept on top of Liberty Mutual rep who rarely returned calls. Finally, the Liberty Mutual contractor stopped by (unannounced) to look again at the windows. He didn’t actually inspect anything but suggested his company could do the work and since he was authorized to approve the windows we would get more approved. It seemed shady to say the least. We told them we already had a contractor we’ve used before and would be using for the work.

    Next day we get a call from the Liberty Mutual adjuster saying 16 windows were approved & the 5 skylights for replacement. This was a shock as the original word form their contractor was 45 windows and the 5 skylights.

    Yesterday we had our own contractor come out and take a look and he agreed with the original assessment of the property claim company and the insurance’s contractor in that 45 windows and the 5 skylights were damaged and needed replacement. He submitted a bid directly to and spoke with the insurance adjuster today.

    I haven’t heard a final answer but what should I do if Liberty Mutual tries to only approve the 16 windows. It seems very suspicious as three contractors (including Liberty Mutual’s) all say 45 windows and the skylights should be replaced. It seems that only after Liberty Mutual’s contractor was told by me he wasn’t doing the work (which I assume is a direct conflict of interest) that he changed his “assessment” and told Liberty Mutual only 16 windows warranted replacement.

    Your experience, wisdom and advise are greatly appreciated.

  974. December 7th, 2011 at 5:20 am #Deb

    HI again, it’s been a few days but I was the last Deb to post the question about water damage. The water is coming in through the roof and siding. I just found out from an inspector that the insurance company sent out that it was due to poor design and workmanship by the builder who did the addition.
    If the insurance company denies the claim, what would be my next steps? lawyer? or just contact the builder to see if his insurance will cover it.

  975. December 7th, 2011 at 6:31 am #Jason

    Deb,
    Perhaps the water that is coming in through the roof and siding is covered. The insurance company won’t fix the poor design and workmanship by the builder. You policy, if it’s like most homeowner policies has a concurrent causation clause it in it. This clause simply states that if a covered cause of damage occurs with an uncovered cause of loss, then the entire loss will not be covered. We don’t know enough about the details of your claim from the information you provided in you posts to provide more information to you.

    The contractor’s insurance may cover the resulting damage because of the contractor’s inability to do this job correctly but it won’t have anything to do with making the job right which sounds like doing the entire effort over from the beginning.

    I don’t know about you but if this is the result of that particular contractor, I would have lost all trust and faith in his abilities to do anything correctly.

    Why would you contact a lawyer?

  976. December 7th, 2011 at 8:20 am #Deb

    Thanks Jason! I may have been jumping the gun with considering a lawyer, it’s just that I’m worried that the contractor won’t want to bear the burden of the damages that ensued from his poor workmanship. The water that has been coming in from the flashing and siding is pretty extensive and is in the front and back of the house encompassing 4 rooms.
    I definitely have lost faith in the contractor but I also don’t want to have to pay out of pocket for the roof flashing work. Would the contractor’s insurance cover someone else to do the repair?
    Do I have another option to have the contractor do the repairs and then insist that it’s inspected by a third party at the contractors expense?

    Thanks again, this site has been very valuable!

  977. December 7th, 2011 at 8:40 am #Jason

    Deb,
    I have lost faith in this contractor too. If he can’t do it correctly the first time, there the odds of him messing up again are pretty high.

    It’s likely that you didn’t do a lot of background work when you got this contractor because of his poor workmanship and with these kind of people – it’s almost guaranteed they don’t have insurance. You get what you pay for and you probably got a cheap job but the results are right in line with what you paid.

    If this is covered by your insurance, your insurance may go after this contractor to collect for the repairs made necessary because of him. Again, I am assuming everything to be accurate that you have posted.

    Yeah, if the contractor has insurance, that insurance would allow you to hire whoever you wanted but it’s very important to make sure you get qualified people to do any type of work on your home.

    You can make any arrangement you want concerning a reinspect by someone else but why? If the contractor is qualified, why go through that extra work? Just get a qualified contractor that can do things without causing more damage. If he does the work correctly, it won’t need to be inspected. I personally believe a job should be done only once.

  978. December 7th, 2011 at 12:49 pm #Deb

    Thanks Jason!

    The contractor is local but has been in business for over 35 years and he is insured. So he’s not completely a fly by night operation. I will be sure to request another contractor regardless.

  979. December 7th, 2011 at 5:03 pm #Kat

    Hi,
    I have the following situation and would appreciate your advice:
    Late September 2011 my tenants noticed 2 gaps in the corners of their kitchen wall. It appeared that the tape in the corners came off and revealed gaps of abot 3.5 inch wide- the wall has separated from the joists. I had several contractors look at the damage and say that it happened because of the snow load we had last winter (I live in Massachusetts). Roof may have more than 1 layer of shingles (I do not know how many)- so the additional weight of the snow started to push the wall out. Once the portion of the wall completely separated from the joists and the nails came all the way out- these large gaps in the corners became visible. Company’s claim adjuster had an egineer look at it. Engineer came out and asked if I tried to fix the problem- according to him the wall separated long ago and somebody tried to fix it. Commerce told me over the phone today that based on engineer’s report, the wall separated many years ago, before I purchased the house, and the issue was concealed, therefore, they are denying my claim.
    Now, I was able to find pictures of the kitchen from 2 years ago that don’t show these large gaps- the wall looks fine. My tenants provided me with a few more most recent pictures of the same wall -one taken this spring may show a slight sign of a problem- the wall probably shifted somewhat and revealed an unpainted portion (1 mm) of the board that runs across the kitchen all. My tenant has also signed an affidafit affirming there were no gaps and she became aware of the loss this fall. I have hired an independent architect/engineer to inspect the walls and provide me with a report of his findings.

    My questions are:
    1. Do I need to get legal involved at this point or do you think I have a chance of fighting on my own by submitting my appeal with all the pictures, tenant’s affidavit, and architect’s report (if my architect agrees with builders)
    2. Commerce refuses to provide me with a copy of adjuster’s and engineer’s reports. They cannon provide me with evidence that would say it was a known issue. The tape that came off in the corners is not wide enough to cover the gaps, so it is obvious the gaps appeared recently. Do I have a legal right to copies of their reports?
    3. Per contractors temporary fix may not bring any results and does not guarantee against further damage, if we had significant snowfall. So it has to be a permanent fix- costly and I need to come up with my own funds. Do I need to wait for Commerce to review my appeal and agree on coverage before I hire a contractor? Time is not on my side. They’ve been dragging my claim for 2 months before denying it and now we are getting very close to the snow season..

    Any other advice, suggestions, opinions will be much appreciated.
    Thanks,
    Kat

  980. December 7th, 2011 at 7:14 pm #Jason

    Kat,
    Do your appeal with the old pictures, your tenant’s affidavit, and your architectures report, whether he agrees with the contractors or not. Also, present all the facts of your position that you can to convince them your claim should be paid.

    I would have to inspect and evaluate the property before I knew what the remedy would be. There are a couple of principles here that the insurance company is ignoring. That would be that your policy covers damage from the weight of ice, snow, etc.

    For example, if a car gets smashed and the front fenders, hood, and bumper are repaired from that accident and the car is then purchased by you, your insurance company cannot and will not say they are not going to repair your car because it was damaged (and repairs) before. What the insurance company is basically saying is they are not fixing your damage because it happened one other time and was repaired.

    The car repair (or the house repair) may not have been the best or most appropriate repair but you purchased this house without the damage you are claiming at this moment.

    During your coverage duration with the policy with Commerce, you experienced damage from a covered peril. What is supposed to happen is an estimate to repair the damage, and payment for something that is sudden, accidental, and needs to be repaired, and your claim should be settled, not denied for something that was repaired with the best techniques and methods as was determined at that time.

    Another example is a leak from a pipe in the ceiling. The ceiling is opening up, the pipe is repaired, and the ceiling drywall is replaced, taped, mudded, and textured. Then the ceiling is painted. Does the insurance company consider this a concealment or a repair? To say the previous attention to this home is concealment is an irresponsible position on their part.

    The insurance is making leaps and bounds by saying what was done is a concealment rather than a repair. Their position is unfounded. This is a very weak denial if everything you present is accurate.

    No, they will indicate that report is something they commissioned and paid for. You can argue their position with the fact the subject of their report is your property they order and paid with your money. Yes, your premiums paid the the engineers expenses and fees for this report.

    Your premiums mixed with the premiums of thousands of other insured’s paid for that report. Your premiums pay their salary; your premiums pay for the office equipment they use; Your premiums pay for every single aspect of what goes on in your insurance company’s office. So, if they really want to be that way, ask them to send you the report you paid for.

    I say you have a right to those reports but a judge many not agree with that because judges seem to be on the insurance company’s side no matter what the issue. It’s not a level playing field.

    If you would like to provide more specific details about this claim, photos, your architects report, etc. you may send to complete.insurancehelp@gmail.com

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  981. December 8th, 2011 at 6:08 am #Kat

    Jason,
    I appreciate your input! You provided some good arguments I haven’t considered. The architect should be inspecting the property today, once I have his report, will forward everything I have to your e-mai. Thanks again.
    Kat

  982. December 8th, 2011 at 6:58 am #Jason

    Kat,
    It’s a giant (insurance company) against you. They have unlimited resources made up of your premiums to do whatever they want.

    Imagine this – If they took the expenses of the adjuster they paid, the engineer that they paid, their time and expenses they invested into denying your claim and instead used all that money to repair your property, the property would be repaired with the money they wasted, they would have upheld their part of the insurance contract, and life for everybody would continue.

    Instead, they should be embarrassed about what they are doing and the lame excuses they have decided to use.

    If there are any public adjusters out there and you are reading this, perhaps you would be willing to donate your knowledge, experience, and advice to Kat to help her on this. I believe this is an injustice.

    I don’t think you should have to spend a dime to get a lawyer involved but unfortunately, that might be what is required. At this point, when your architect has completed their report to you, the best route for you right now is to appeal their denial.

    Please advise what engineering firm Commerce used.

  983. December 8th, 2011 at 12:19 pm #Kat

    Jason,
    I have all the reasons to believe their denial is ungrounded, but I as a consumer I have very limited resources, which makes it more difficult to fight Commerce. There’s not much knowledge available out there, I am collecting bits and pieces of information from all the sources I can put my hands on.
    The architect/engineer came out today but left very promtly after I asked to sign an agreement detailing his services and payment. He wanted a full payment upfront which sounded sketchy to me. For some reason it appears to be difficult to find a structural engineering firm in the area that would provide services for residential- all work with commercial properties. I probably called a dozen companies. I am still calling around to see if I can find a reputable engineer willing to inspect the property.
    The name of the company that Commerce hired to inspect my home is Cianci Engineering out of West Hartford, CT.
    Kat

  984. December 8th, 2011 at 12:37 pm #Jason

    Kat,
    Think about it. Why do you need an engineer or architect of your own? You know what the wall condition was like before. You had the weight of snow damage it and that is apparent with it’s current condition. You don’t need anybody to tell you that.

    What Commerce did was got somebody with more perceived credibility to write a report that anybody could have done. Commerce is then basing their denial on that perceived credibility and making up an excuse that it was concealed to deny your claim. (repairs are always concealed so it doesn’t look like it was repaired or worked on) There is no exclusion in your policy for “concealing” anything as far as repairs are concerned. In fact, a contractor would not be doing the repair correctly if he left things undone and open so you could tell a repair had been completed.

    Insurance companies hire these kind of professionals all the time and these people know the insurance companies will pay after the work is done because insurance companies pay. Regular customers don’t use these engineers the same way so they don’t want to do work and not be paid. So in order to keep their clients (insurance companies) happy, they almost always come up with a report that is favorable to insurance companies.

    Is the abnormal? No, it’s normal because people want to to like their work product or results. When this engineer produces results the insurance company can use to deny with, then the insurance company like it, and this engineer likes it because he now has another satisfied customer that got what it wanted. In this case everybody wins and the customer (you) lose.

    Please send photos.

  985. December 8th, 2011 at 2:03 pm #Dodie

    I was robbed in August and the thieves took off with laptops video cameras as well as 35mm cameras. They also took off with my pride and joy CD collection which consisted of over 200 discs. My replacement cost was around $6000.00 with a $1000.00 deductible. Now I really didn’t expect to get $5000.00 back but my insurance company came back 2 months later and said most of what I lost were considered “limited” items and were not covered. What else exactly do thieves usually steal if not these items. The claim is for $615.00 and I am at a loss and do not know what to do.

  986. December 8th, 2011 at 2:49 pm #Enrique

    Last week I have a water leak in my kitchen. My insurance company gave a estimate and will be released next week. But according to the Agent it was named thru Us and the Mortgager (Bank). We plan to hire a good friend to fix the problem ( He is working in a legitimate contractor).And we know the fact that he is good. Compared to a contractor we can save a little bit and put the money to upgrade the material to be installed. (example: instead of laminate countertop will try to install a granite instead).

    Is there gonna be a problem with the bank.??

  987. December 8th, 2011 at 5:22 pm #Kat

    Jason,

    I have forwarded you the photos of the damage along with older pics of the wall.

    Kat

  988. December 9th, 2011 at 6:00 am #Jason

    Dodie,
    If your claim is for $6000, that is about $30 per CD. What is the value of your computers, video cameras, and cameras? What is the value being allowed for each of those items. Is the $615 based on your ACV value or your replacement value? Do you have a replacement policy? Also, does the $615 include your deductible or not?

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  989. December 9th, 2011 at 6:08 am #Jason

    Enrique,
    There should be no problem with your bank. You bank simply wants to make sure the damage is repaired so they have the same value for the collateral they have securing your mortgage loan. Simply send the check to your bank and ask the bank how to obtain the funds and let them know what you want to do.

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  990. December 10th, 2011 at 10:46 am #Dodie

    The $615.00 is after $1000.00 deductible and I only claimed $10.00 each on CD collection. I had 4 cameras 1 video camera 2 laptops ( 1 of which was only a month old.) My adjuster told me to list everything right down to the orange juice and incense burner that was stolen. There were alot of things taken but I’m confused mostly at how the cd collection and cameras were considered limited items. I had to scan and email every cd jacket of the discs taken. Shouldn’t the adjuster know they wouldn’t cover these items ahead of time? So far they have shown me nothing of what was covered and what wasn’t. I had to call to find out what was happening with my claim they told me the adjuster had the check about two weeks prior to me calling. I heard from him about two weeks after that conversation and he was telling me I have to sign a “proof of loss” form before I can recieve my check. I have avoided his phone calls until I can figure out what to do. I have no copy of my policy so I feel I am up against a wall. The check they want to give me is a joke.

  991. December 10th, 2011 at 11:18 am #Jason

    Dodie,
    So the value of your claim is $1615. You really need to find out more about your claim. Generally, people have replacement coverage with their insurance and you will be paid ACV until you replace the stolen items. I don’t know anymore than you do about your claim but that is exactly what I would want to know. Do you know what “limited items” means? Well, if you don’t, you owe it to yourself to find out so you are not in the dark. What replacement means is that once your replace all the items you had stolen, you will be out $1000 and you will have everything replaced (and brand new).

    Why don’t you stop avoiding your adjusters phone calls and either answer his call or call him on your own so you can learn more about this process?

    The check they are offering is not a joke. What is a joke is that you don’t understand the claim process and you are doing nothing to learn about it. You are not going to learn what to do about your claim until you first can figure out what it’s about. In your case, learning a little bit can be the difference between having a good claim experience or a bad one.

    Yes, you will have to sign a proof of loss. That is a formal claim document outlining what was stolen and this is legal document that can be used in court. For example, that document can be used to support your loss if the insurance company finds the person that stole your property to ask the judge to order this guy to pay back what he stole from you to reimburse the insurance company for what they paid (and also to get your deductible back.)

    You will learn what is covered and what isn’t covered but you will not learn of that by avoiding the adjuster. Get involved in your claim so your can reduce or eliminate the frustration level you feel about the entire process. It’s not only you that’s frustrated by your avoidance, it is also your adjuster.

  992. December 12th, 2011 at 10:53 pm #Ted

    Ok so we lost our mobile home to a fire last saturday,, come to find out the coverage was for structure only!!! my question is, since the insurance company has sent out an adjuster and they do have the report from the F.D. and everything with it being a total loss and they are payin off the remaining mortgage do they have to give us the remaining amout of the isured amount? and can it be removed and or destroyed before they “release” the title.. The park it is currently at has told us it has to be removed by the 1st or the month however the insurance comp. is telling us it could take up to 30 days to finalize all the paperwork.. can i legally “dispose” of the unit without the title? or will i have to pay another months lot rent due to them not processing it quick enough??

  993. December 13th, 2011 at 11:54 am #Jason

    Ted,
    We don’t know how your policy is written so we don’t know how the settlement will take place.

    Those questions should be addressed to your adjuster and your mortgage holder.

  994. December 13th, 2011 at 2:31 pm #concerned

    if damaged areas are repaired using upgraded material and labor on a replacement cost claim will there be any problem with collecting the depreciation value holdback from the insurance co… do they care ….

  995. December 13th, 2011 at 3:56 pm #Jason

    Concerned,
    No, there should be no issues. You will have to pay for the difference between what was damaged and what you replace it with. However, if you want to make sure there are no surprises, you might want to discuss this with your adjuster.

  996. December 13th, 2011 at 6:31 pm #concerned

    thanks for your input

  997. December 14th, 2011 at 12:15 am #Tommy

    Five years ago my AC broke and we had a flood in our kitchen and garage area. It was a slow leak and it took us around five days before we realized our hardwood floor turned colors. Their was damage to the floor, drywall in three rooms. AAA of southern California came in with their contractors and fixed all the damage. They brought blowers in but did not setup a contamination field the first night. My wife became very sick about a year later. So sick she was bedridden for seven months. I had to get a nanny to take care of my kids so I could work. We saw many doctors and have spent thousands of dollars trying to figure out why she was so sick. Her doctor checked her blood for mold exposure. She tested positive. The doctor instructed us to have mold testing done on our house using an ermi and mold inspector. It came back positive that we had mold from a previous water damaged building. The ONLY flood we had was that event. The inspector said that it was not remediated properly and it caused mold to grow and got my wife sick. I called AAA and reopened the claim. They drug their feet and switched agents on me. They finally sent out a team of seven experts to do tests of all kinds on my house– mold, structure, plumbing ect…it too them nine hours to do all the tests. Conclusion was no mold. To make matters worse. The mold found from my mold inspector was found in the hvac unit, meaning the unit had spread the mold spores through the entire house resulting in 100% loss of everything I own until it is remediated. aaa stands by their claim of no mold, but I have reports saying their is mold. They sent me a denial letter. This process has taken almost a year. I am exhausted from fighting with them. I have paid double mortgages, house and apartment for my family to live in. I am ready to be done and move on or should I? I have a lawyer who wants to fight but I am honestly so tired and so drained from having to take care of so much I have no fight left. I am not sure who believe aaa or my mold inspector. I have two routes to go to fix my house. One costs about $5k and the other about $18k ( this is full remediation) the other is clean and no mold. I can rent the house and make income and move on. So what do I do? Cut my losses and move on or do I file a lawsuit against aaa? The lawsuit would be for repair of the house, replacing our stuff and health for my wife. I have heard and read it is very hard to prove the health when it comes to mold. My lawyer wants to go after aaa and the company that did the repairs. I don’t even know if it will be worth it. Aaa pulled out some heavy bitters for inspectors. I checked backgrounds and they are all major players in court cases for the insurance company. Any advice would be helpful. Not sure who to listen to. Thanks.

  998. December 14th, 2011 at 8:19 am #Jason

    Tommy,
    Thanks for presenting your post in a clear and logical fashion.

    I will address 3 things and you can then likely make a decision based on this information of a third party looking in.

    First, your attorney is on your side, he provides the best legal information relevant to your situation that he can muster. He has experience in the courthouse and can step toe-to-toe with big companies. Although he is on your side, that doesn’t mean his interests are the same as yours.

    He is not there to help you in the slightest with your finances or your business decisions; both of which are very important to you right now. We can say with certainty that this attorney of yours will get paid regardless of the outcome of your claim going back 5 years. That is because you are paying him hourly and his expenses. Is it in his best interest if he can continue to bill you hourly or if you drop the case? Depending on your decision, in one scenario he continues to be paid by you – in the other his income from you stops.

    Second, mold is everywhere in our environment. Many different kinds. Mold is airborne and we can guarantee that everybody has some amount of mold presence in their body at all times. When your wife tested positive for mold, that doesn’t surprise us. You would have tested positive for mold too. The doctor’s that performed the mold test would have tested positive for mold as well – it’s everywhere.

    Judges know mold is everywhere and that test provides no direct correlation between the mold in your home and the condition of your wife’s health. If a jury doesn’t know about it, the testimony of the insurance company and their witnesses will make that very clear and before the jury deliberates that the jury will know that there is no correlation between the two.

    The burden of proof is on your attorney and you to prove that the insurance company and remediation company did something incorrect in their handling of the situation. But before you can proof that, you need to establish that there is a connection between that and your wife’s health condition. Can you and your attorney prove those 2 things?

    Third, let’s just say your attorney and you will be able to prove that both the insurance company failed in their efforts AND their failure caused your wife’s health to deteriorate. The judge or the jury would then have to put a dollar amount on that as far as compensation. If your attorney and you barely proved your case and the judge or jury doesn’t consider their failure to be worth much, they could say you win the case and award $0 in monetary fees to you. Or, the judge or jury can be convinced entirely that one or both of these companies dropped the ball and caused considerable hardship to your family. They could award more than $0 but that is another element that your attorney and you would have to prove as far as what you should be reimbursed.

    5 years have passed. Your attorney’s income from you is not dependent on whether or not he is successful with this claim. You did a little research and you know the insurance company does not plan to lose and so far, their experts and witnesses are “major players” (in your terms). The resources of the insurance company are unlimited meaning they can hire as many attorneys for as long as they want and it won’t affect the company. Each day this creeps forward, your family feels the affects and costs of continuing. The burden of proof is on you and your attorney, so until you pass that threshold, your case remains unproven.

  999. December 14th, 2011 at 8:21 am #Jason

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  1000. December 14th, 2011 at 9:50 pm #Tommy

    Jason, thank you for this wonderful input. My wife and I want to put this behind us and move on. The idea of possibly fighting another year or two years just doesn’t make sense to us. All we really want is for aaa to fix our house and replace our stuff. But I can’t wait for them any longer. Many thanks for your advice.

  1001. December 15th, 2011 at 9:43 am #Jason

    Tommy,
    Some people may think that our advice is biased in favor of insurance companies. We don’t agree with that. The information provided on here is to make people’s lives easier without a lot of undue stress or misconceived objectives that will never be realized.

    Our post to you could have been short and consisted of, “Just drop the case and move on with life”. However, that would not have been enough for you. You are frustrated and you have lost your will to fight. There is more to life than fighting battles no matter how wrong the other party is.

  1002. December 15th, 2011 at 11:33 am #Emely

    We had a water damage in our home.. After 3 weeks we received a settlement fund. While reviewing the list of the damage that the Adjuster submitted. We found out that some of the damage is not listed in the report. We try to contact the insurance agent handling our case for many times and it’s seems like she avoiding our calls. We are planning to hire a 2nd opinion thru a public adjuster after the insurance keep on avoiding our inquiry.. Is this the legal step to take?

  1003. December 15th, 2011 at 1:57 pm #Crystal

    I inherited a house in Alabama upon my Mother’s death. House was jointly owned by my Mother and Stepfather as a rental dwelling investment. Stepfather had rental dwelling insurance policy through State Farm, he was listed as the Insured. Both my Mother and Stepfather passed in 2008. I am Pers. Rep. for my Mother’s estate; her Will states any property she owned is bequeathed to me. I notified insurance company that insured is deceased and to send billing notices to me as new owner of property (hired an Alabama Attorney to legally transfer property ownership to me). I’ve paid the insurance premiums yearly since their deaths. The property has been on the market for sale. In October 2011, house was vandalized; police report was filed. State Farm is sending the check for damages to me payable to the Estate of my Stepfather. They say they are required to do this even though I am the current owner of the property. I am not the Pers. Rep. for Stepfather’s estate; only for my Mother. I explained to them that I will not be able to cash the check, yet I am required to repair the damages to the vandalized property. Can State Farm do this? Do I have any recourse as current owner of the property?

  1004. December 15th, 2011 at 4:44 pm #Jason

    Emely,
    Sounds like a reasonable thing to do. Yes, it is legal. The adjuster seems to want to avoid having to do extra work with the few items that were overlooked. With a public adjuster, this insurance adjuster will be doing a lot more extra work having to deal with a public adjuster.

  1005. December 15th, 2011 at 5:06 pm #Jason

    Crystal,
    Perhaps you have to get your stepfather’s personal representative to address this for you. The insurance company is doing everything correctly. They have to protect both insured’s interests by naming each of them on the check. This might require obtaining the assistance of another attorney.

    You might be current owner of the property your mother’s portion of the house but how of a sudden did you become the owner of the entire house?

  1006. December 16th, 2011 at 7:47 am #Emely

    Thank very much Jason,

    When I called the adjuster. he said,he missed that part of the house and have no picture.(Because he only inspect once) So he’s going to go back to inspect. About the insurance examiner who’s handling our case according to the Supervisor she’s no longer working in the company. So they assign us to a new person. Is that a tactics to delay the issue??

  1007. December 16th, 2011 at 9:59 am #Crystal

    Jason,

    In my question above, I did explain that the property was jointly owned by my Mother and Stepfather (joint tenants with right of survivorship); Stepfather died first in 2008; therefore my Mother became the surviving owner of the property. She died later in 2008. Her will bequeathed any property to me; that is how I became the owner of the entire house. The property has been legally deeded to me.

    Thank you for your answer, but I will not involve the Stepfather’s Pers. Rep. as they have no legal interest in this property.

  1008. December 16th, 2011 at 3:21 pm #Jason

    Crystal,
    Your step dad’s survivor’s may not an any interest in this house but they do have an interest in the insurance policy and the damages that occurred.

    Unless you have some magical way to unravel this without involving you step dad’s heirs, it seems like you will have to involve them. Sometimes going to the focal point of the problem is the most logical thing to do. Although this could have been sorted out a little bit better with some planning, it wasn’t and you are left to deal with what it is.

    I again read your post. Your mother owned the property, now you do. Your step father was always the insured even though you were paying his premiums. One way to resolve this is to send the check to your step dad’s heirs and let them cash the check. That way you don’t have to be involved with them. Just as they don’t have a legal interest in the property, you don’t have a legal interest in the insurance settlement money.

  1009. December 16th, 2011 at 3:27 pm #Jason

    Emely,
    It probably isn’t a tactic to delay. They probably just had some employee turnover and things got missed. So, if they agree that they missed some items, your estimate may become complete after they reinspect and re-do the estimate. Hopefully you won’t have to involve a public adjuster. A public adjuster doesn’t intervene for free so you might be able to avoid the fees associated with a PA.

  1010. December 16th, 2011 at 6:12 pm #Tammie

    My house caught fire August 24, 2011. I am insured with Tower Insurance Group out of NY (I live in Northern California) and at first the insurance company was very proactive, then within 2-3 weeks the promise of two months of ALE and the 80K needed to start the repairs was given. No money was sent and on October 26, I was advised that my claim was being assigned to someone else. I got the contact information and to my horror/surpise, it was a legal firm in LA. I was scheduled to do an EUO on 11/15 and I was just told by my PA (had to secure one 10/31 due to the threat of denial completely) that the attorney is going to advise Tower not to cover my ALE or contents (will cover my children’s stuff) since he doesn’t THINK I lived there and that he feels that I am lying. He wasn’t able to PROVE it, but based on his assumption, this will be his recommendation. Is this legal? Can an atty advise based on his personal feelings, vs the facts?

  1011. December 16th, 2011 at 6:21 pm #Jason

    Tammie,
    We’re sure they are not his personal feelings. That may be one way to look at his recommendations but they are likely based on facts and circumstantial evidence.

    We don’t know all the details of the circumstances or your claim but it must have something to do with whether or not you live at the dwelling.

    The attorney can make any recommendation they want to make.

  1012. December 16th, 2011 at 7:44 pm #Keith

    My house was flooded in Sept.2011 in PA. I hired a public adjuster. He has not done anything for me. We used the insurance company’s proof of loss. He did not file an appeal. Now that I settled with the insurance company he wants his cut which is around $20,000.00 dollars. Do I have to pay him?

  1013. December 16th, 2011 at 9:02 pm #Jason

    Keith,
    You hired him and very likely signed a contract. Technically you owe him. It might not seem like he did much, if anything, but that has little to do with the contract you signed with him.

  1014. December 17th, 2011 at 3:18 pm #Keith

    My hired public adjuster also had me have the house dried out by a company that cost $6500.00. The insurance company has only alotted $2500.00 in the proof of loss. Should the insurance company pay the full amount? Also the insurance company is only paying for 8 feet of siding, shouldn’t they be paying for all new siding for the whole house so it will match up and fit correctly? The old siding is aluminum.

  1015. December 17th, 2011 at 9:03 pm #Jason

    Keith,
    These are perfect questions for your public adjuster. Since he is more intimately related to your claim, his answers will be more accurate than anything we can provide.

  1016. December 17th, 2011 at 11:55 pm #justme222

    Tammy,

    if you really live there then a lawyer can’t prove you don’t….that’s impossible. if they deny your claim based on a lie then you should be more happy than anything cause you will have a fantastic lawsuit. if they are right………be careful.

  1017. December 18th, 2011 at 7:44 am #Jason

    Tammy,
    Lawsuits are not fantastic and I don’t think anyone is happy that they have to resort to the court system to resolve their concerns.

    As for establishing where someone lives – that is not impossible. Our information on here has to be accurate so the words we use have to be carefully selected. Surveillance, interviews, EUO, and a number of other means can be used to establish residency.

  1018. December 18th, 2011 at 9:11 am #justme222

    Jason,

    First of all you need to READ before you make dumb comments. I stated that if she really lived there then they cannot prove she don’t. How can you prove a dollar bill is purple? You can’t, because it aint. Don’t let your arrogance get you checked. If you don’t know, it’s best not to say nothing. The quicker you learn that the better off you will be.

    Secondly, lawsuits are Great in some cases. I’m sure in her case it would be. Can’t you follow the context of her comments. She could turn a $80,000 claim into close to a $300,000 lawsuit due to the insurance companies arrogance and stupidity…..see what I’m saying? You have no idea how that could benefit her and her family, but I’m sure you wouldn’t understand that cause you probably rich. Maybe that’s why you on here trying to get paid to give advice. You ought to be ashamed of yourself!!!

  1019. December 18th, 2011 at 9:40 am #Jason

    Justme2,
    I don’t know any situation that anybody would need to prove the color of a a dollar bill. That is irrelevant to this claim situation.

    The information provided on here is simple, basic, and based on the information presented. It is difficult to understand what you mean by “get you checked”. Slang terms provide no benefit to anybody.

    No, lawsuits are not great. If your are sure the suit in her case will be great, I’m sure you will finance it, right? Misleading people about the legal system is careless and that will never be found in any post submitted by me.

    You have to understand that not everybody is arrogant. You indicate in your post that I am arrogant and so is the Tower Insurance Group insurance company. There is a reason for the EUO and we have not been provided that information. I don’t assume things because that doesn’t benefit anybody.

  1020. December 18th, 2011 at 9:42 am #Jason

    Justme2,
    If you want to provide critique information to me, you are welcome to that by sending it directly to complete.insurancehelp@gmail.com That way it doesn’t have to be part of his question and answer forum.

  1021. December 21st, 2011 at 8:02 pm #Charlene

    Well here we are finally finished with the restoration of our vacation home after our claim for water damages. We lost everything inside either due to water or mold, and the place so far has cost over $100,000.00 to restore. My question now is that I did not receive a check for our personal items lost until September 30th (filed claim in April) and yet initially my adjuster wanted me to turn in any or all receipts for those items I was replacing by October 19th…just 3 weeks after receiving the check.

    Well at that time they had not even replaced sheet rock and were working on the restoration of the structure and I argued I was not going to put in new couches, televisions etc in the middle of the building process. I was given or rather granted an extension to Jan 1st which the adjuster felt should give me approx 30 days after the estimated completion date our contractor provided us. Here we are with 1 week to go and I’m frantically fighting holiday shoppers etc and feel that this is really not fair to us to have this all done by the 1st of the year.

    What is the law regarding this part of the process? Also should we have been given compensation for the loss of our vacation homes use since April to the present? I really would appreciate some advice on both of these fronts.
    Charlene

  1022. December 22nd, 2011 at 8:41 am #Jason

    Charlene,
    There are time limits to get the repairs made and the replacement items purchased. You have an extension and that is great that your insurance company is granting you that. If there were longer deadlines, people would stretch those out as long as they could.

    You likely were paid the ACV of the damage to the personal property and in order to claim the replacement cost, you have to physically replace those personal property items.

    Perhaps you can ask for another extension. If you do get an extension, get it is writing because your policy has the time limits in writing and you are already passed the time in which you are allowed.

    The loss of use or fair rental value can be something you can discuss with your adjuster and how they approach that. We would comment but we don’t know if you have loss of use on this property you own. It’s fairly common on your principle residence but additional properties don’t always have this coverage.

  1023. December 22nd, 2011 at 8:52 am #Charlene

    Jason,
    Thanks for the advice, yes I was given the funds to repurchase my personal items, as I stated the problem is now that the work is finally done (mid December) it has given me only a short window of time to do it as that personal items check wasn’t received until 6 months after I filed our claim. I understand about the time limits placed on refurbishing our home, I will hope for an additional perhaps 2 weeks extension…or else I guess I shop till I drop!
    Charlene

    I will double check the loss of use clause on our policy and hope for the best.

  1024. December 22nd, 2011 at 9:15 am #Emely

    @Jason,
    May be your right. The Adjuster re-inspect the cabinet and he saw the opening cause by the plumber to see the leak. But the issue is he doesnt want to replace the cabinet and advise it to just repair it. He said the cause of the damage is not from the water leak but from the plumber made the opening to access the damage water hose (Frig). In you opinion, Is he right not to replace it because the plumber made that hole in the cabinet?? I tried to reason with him but no avail…
    Well the funny things was. When he left my house I felt I have to do something. So i crawl inside the cabinet and tape my iphone in a stick to access some part of the cabinet with he did not bother to take a picture. I found two of my kitchen cabinet actually has
    water damage in the bottom. I send the picture to him and he said his gonna hadle it from here. Did I justify my case that he should replace the cabinet??

  1025. December 22nd, 2011 at 9:38 am #Jason

    Emely,
    The access hole in the cabinet is not direct damage. It is indirect damage caused by the plumber. Yes, the plumber had to do that but it is, by definition, excluded as damage that your policy covers.

    I don’t know what will become of the photos you sent. It probably will justify replacing the cabinets that are damaged.

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  1026. December 23rd, 2011 at 4:39 am #mickey

    I have a unique situation. My home was damaged by hail in May so I made a claim to my insurance SF and they were fast at getting me adjusted and a check written. The problem lies at my mortgage, Liberty Savings Bank, they are holding my money on work that is now completed and out of pocket paid in full accept for 2 small items like gutters and a window well cover. I am out over 5 grand and had to be late on my mortgage payment to repair this. Now they are saying I cannot receive any money until my loan is current butt yet I have paid out on their home for repairs. I offered for them to deduct the payment from the check of over $8600 butt they have me jumping through so many hoops that it is impossible and when I have to pay for the repairs and labor i now am broke and see no help or cooperation from my mortgage company. What can I do?

  1027. December 23rd, 2011 at 6:56 am #Jason

    Mickey,
    Your question is not about insurance; it’s banking related.

    Get your mortgage payments current. The way you indicated they won’t release the funds is that there is more than a $2 window well cover missing. If the gutters are not replaced, have them withhold the entire amount of the gutters.

    But, first and foremost, you have to get your payments current. It’s not just 1 or 2, it’s more than that. This insurance money is not to catch up on mortgage payments, it’s to repair your home.

    You indicate they are making you jump through so many hoops that it’s impossible. Think about it – all they want you to do is make the repairs and get your mortgage payments current. Those are not a lot of hoops.

    It’s very likely that they gave you an initial draw before any work was done, then they offered to pay another 1/3 after so much work has been done. It is unlikely that they have more than 1/3 of the funds in their possession.

    Sure you may have made down payments to the contractors for the repairs but it’s difficult to fathom that you paid these contractors in full for their entire contracts. If you have and you have documentation of that, send those “paid in full” receipts to us at compete.insurancehelp@gmail.com and we will call your bank directly to get as much funds released as possible for you.

    The more we review your post, the more it doesn’t make sense. Either the bank is way off in it’s handling of your repair funds or there is a lot more about the damage and repairs we don’t know. If there is additional information we need to know, you can elaborate when you submit the receipts to the above mentioned e-mail address.

  1028. December 23rd, 2011 at 11:10 am #Lisa

    There was a post earlier regarding a friend who helped with the claim w/r to researching etc. The claim rep. is trying to deny the invoice although monies were spent for that help. Can anyone please shed light on this matter?

    Thank you.

  1029. December 23rd, 2011 at 11:13 am #Charlie

    Can someone please inform how you have been successful with the insurance agency paying for the third party administration of claim assistance?

    The insurance company is stating that it is not covered. Your insight will be helpful.

  1030. December 23rd, 2011 at 12:01 pm #Jason

    Lisa and Charlie,

    You seem to be asking the same thing.

    To Lisa, what kind of researching was done?

    To Charlie, what assistance was provide?

    Why do you believe the insurance company is responsible for a contract you entered into with another party? That is like saying the insurance company is responsible for toll road charges you incur because you travel on toll roads.

  1031. December 23rd, 2011 at 2:22 pm #Yvonne

    I live in Arizona and am in the midst of repairs from hail damage done to my house in 2010. The roof has been replaces, the a/c units repaired and the final payments to those businesses are en route to pay them off. There is still work to be done on other areas from the storm, some will be done in spring by hired help and some I intend to do myself, such as painting, replacing gutters, etc. I don’t plan on doing anything requiring a license such as plumbing or electrical. Just the easy stuff. I still have ample funds sitting in a special escrow of my mortgage co who is giving draws.
    However, my problem is they are reluctant to issue funds until I can prove to them that Arizona allows home owners to do ANY of their own work. The mtg co told me they read I can only do up to $750 worth myself. What I know of that amount is that someone, like a painter, has to be licensed with the state if the job he is doing is more than $750 and subject to contractor quality or something to that effect.
    I do not believe that this $750 limitation applies to the homeowner them self and if it does, nearly everyone in the state would be in trouble for their own handiwork inside and out of their homes. I have tried to locate specifics on what AZ allows, which I am now required to submit AS PROOF to my mtg co to receive a draw to purchase paint and gutters etc as I don’t have the front money in hand.
    Any suggestions you can provide would be greatly appreciated. I’ve never had this much trouble following through on a claim in my life and about frazzled from the massive runaround I’ve had to deal with just to get checks deposited and companies paid for their work.

  1032. December 23rd, 2011 at 2:33 pm #Jason

    Yvonne,
    We don’t know the AZ requirements concerning contractors. This isn’t related to insurance.

  1033. December 23rd, 2011 at 3:03 pm #Harry E

    Charlie –
    In addition to Jason’s perspective, I can add another thought I think and a different analogy. It sounds as though you are hiring an Adjuster to represent you, as opposed to the Adjuster which an Insurance Company hires to represent its interests, is that right?
    I have hired an Adjuster, and because one is not required by the company for insurance payments to be calculated or estimated, this adjuster is usually paid as a percentage of payments you get from the Insurance Company, and is paid out of those proceeds. To extend Jason’s analogy, this is similar to payments you make to a lawyer to represent you; the other side very seldom has to pay these costs, you pay them because you choose the lawyer after you decide that it is in your best interests to hire any lawyer, and specifically that lawyer, at a cost which you negotiate with your representative.
    One odd thing here is that you would expect the Adjuster to maximize payments to you in order to get the most money for himself. Be aware that in some cases, the Adjuster can make more money by maximizing payments regardless of who those payments go to; in such cases, I have seen examples where the Adjuster immediately sells out the client who hired him in favor of maximizing his dollars by increasing money paid by the company to other people. Be very careful and farsighted in thinking about the contract that you want to sign if any payments from the insurance company might go directly to contractors etc.

  1034. December 24th, 2011 at 6:37 am #Jason

    Harry E,
    Thanks for your post. If you have posts like that, it would be great if you responded to all the questions posted on here.

  1035. December 25th, 2011 at 7:32 pm #admin

    Jason,

    Ditto on Harry E comments.

    Charlie,

    I think it would be very helpful if you could specify what kind of “third party” you are talking about, a public adjuster, independent adjuster, lawyer, accountant, appraiser, inventory company, building contractor, autobody shop, other etc?

    What kind of compensation, hourly fee or percentage of claim, contingency fee?

  1036. December 26th, 2011 at 1:42 am #Harry E

    Jason,
    Thank you for your very kind statement. I will try to come into discussions when possible. If there is a way to send messages (my statement about my ‘limits’ would tend to be of interest to only a couple folks, not most readers) off-board, I can fill in some details about the kinds of issues that I may have some experience in and see where you think I might add something to the mix.

  1037. December 26th, 2011 at 5:00 am #Jason

    Harry E,
    There is not a minimum education or experience requirement required on this site. People come to this site looking for insurance advice and direction and if you are able to provide assistance in that regard, then that would be great.

  1038. December 26th, 2011 at 10:29 am #Yvonne

    Jason, thank you for your answer, but the funds I am referring to the mortgage company withholding are insurance funds, meant to repair damage done to my house. Can my mortgage company force me to use hired/contracted help for non-licensed related repairs simply because they are holding the funds? I am the homeowner and I pay for the insurance. The only reason they chose to hold the funds was because the claim was such a large amount, over $20K. This was to ensure I do the repairs, which I am doing, but I can’t do the ones I want to do myself without a draw from the funds to buy the materials.
    Thank you.

  1039. December 26th, 2011 at 12:45 pm #Jason

    Yvonne,
    Yes, we know the funds are insurance funds but that is the only relationship your situation has to insurance. It’s the mortgage company that you have issues with.

    You even reinforce this in the very next sentence when you ask, “Can my mortgage company force me to use. . . “. You have to realize this is entirely about your mortgage company.

    If you need to buy materials, charge the materials on a credit card, borrow the money from the bank in the form of a loan, use your savings, borrow from a friend or family member, etc. There is a vast array of things you can do to get your materials.

    Please note that paint is not that expensive. I find it very unlikely that you are going to replace gutters. I really don’t believe your concern is about the mortgage company releasing the funds to you based on their policy for any borrower who runs in to this type of situation. There is more to this than you are revealing to us and it is very unlikely it has anything to do with insurance.

  1040. December 26th, 2011 at 6:44 pm #Yvonne

    Jason, I find your condescending tone less than appropriate in your response. I have no idea why you feel there is more to this than what I stated, but you assumed wrong. I am widowed, on a fixed income and raising two college kids and younger one. I don’t have spare change most of the time, so yes, paint is expensive when the bills come first and there is no leftover.

    I am intending on replacing the gutters that are damaged and leaking from the storm, and part of the covered items of my polity, yet another failed assumption on your part.

    My concern is that everyone, mortgage company AND my insurance company, has an interest, myself especially, in getting these repairs done with monies insurance INTENDED for repairs that are being kept from me and preventing me from using them for their intended purpose.

    I realize that my question is a bit off the usual mark on how to get insurance companies to pay up, since mine is a decent company and gave me no grief in this matter, as a customer of theirs for thirty years, but since I hit a brick wall on how to get the funds released due what seems to be industry standards of practice when the insurance claim is so high, I thought you might at least provide options of who I could contact.

    I appreciate you taking the time to read my questions and respond. Unless you have further information that might be of use to me, there is no further need for you to respond to me in this thread.

  1041. December 27th, 2011 at 8:44 am #Jason

    Yvonne,

    We attempt to keep the topic in here insurance related so we don’t have all kinds of information that is not related to insurance. We don’t know the banking procedures or policies concerning a mortgage company’s requirement to repair collateral secured with the loan. Another thing we don’t know is the insurance requirement banks request home owner’s to have when they also have a mortgage with that particular bank.

    If you would have searched this forum before posting 3 times, you would have found question #607 and #928 (and their responses), and had information that this isn’t related to insurance. Now when people inquire about banking issues, we can refer them to questions #607, #928, and your 3 posts.

    Now, this IS insurance related – The funds your mortgage company has is likely the ACV portion of your claim (but we don’t know for sure). Most insurance policies require the repairs to be completed within a certain time frame in order to collect the recoverable depreciation (if you have a replacement policy). If you intent to receive all the benefits of your insurance policy, this is an important part of your insurance policy that many people are not aware of. (This topic has been covered in this forum.)

  1042. December 27th, 2011 at 3:50 pm #Melissa Jordan

    Can a spouse file a claim or a wrongful death suit against a homeowners insurance policy if the other spouse was murdered on someone elses property? Not our own insurance policies, but against the actual homeowners policy where the incident occurred? If it means anything different, the shooter also committed suicide at the scene, so I can not file a claim against the actual shooter.

  1043. December 27th, 2011 at 4:02 pm #Jason

    Melissa,
    A policy for this shooter is an instrument that protects the owner of the property from claims against the owners if there was something negligent or at fault the property owner did or failed to do that would otherwise be reasonable or expected of that person.

    It however, doesn’t provide coverage for intentional acts. If the shooting was accidental, then perhaps but this is likely an intentional act and coverage would not exist.

    This is not legal advice – you may be able to file a lawsuit against the estate of the shooter if there is anything of substance that you may be able to collect. That would require you to involve an attorney.

  1044. December 28th, 2011 at 4:32 pm #Barbara

    Texas Farm Bureau denied my claim, listed me as a suspect in the arson of my home stating that I either burned my home or directed someone to do it. They are telling me that I must pay the premiums for the new policy to keep from causing the claim to be denied since I am disputing the decision. They recently sent me a renewal policy for 2000.00 dollars more on the structure and 1000.00 more on contents and the house was considered a total loss when I filed the claim on Aug 2011, but they are telling me I must continue to pay the premiums and once the claim is closed they will reimburse me for the premiums paid up to the closed date. ARE THEY SERIOUS?????? Contacting an insurance lawyer for help BEWARE OF TEXAS STATE FARM BUREAU

  1045. December 28th, 2011 at 5:40 pm #Jason

    Barbara,
    The premiums now are based on all the same things but with that added element that they are insuring someone that has burned their house in the form of arson. The rates seems about right.

    Now, the date of loss is set in stone – that will not change. Your policy is an occurrence based policy meaning that if a loss occurs during the policy period, then that claim is considered for that policy period.

    If you dispute their determination, you don’t have to keep a policy in force. That would not make sense. You don’t need to pay premiums any longer, in fact you don’t have to pay premiums for anytime after the fire loss for this claim to be a valid claim under the policy period for the claim you’ve made.

    I don’t know who is telling you this information or if you are not understanding it correctly. You should actually cancel your policy the day after the claim dates because it is a occurrence based policy, not a claims-made policy.

    Once they started examining this as an arson fire, that is when you needed an attorney. It might be too late to get one right now.

  1046. December 29th, 2011 at 10:17 am #James Longwell

    First, Thank you for your help.

    I was of a mind that I may be a bit more savvy than the average claimant, because I used to work in insurance; but that was a long time ago.

    Boy, was I wrong. Just where does an insurer get off claiming depreciation when an insured has RCV on their HO policy?

    My home was damaged by a Hailstorm on OCT 5, 2010. Not only was my roof damaged to the point where it no longer kept rain off my head; but in addition to that, a relatively new 13 seer heat pump was damaged as well as a tool shed and several items of my children’s playground equipment.

    An adjuster came out and assessed the damage at around $13k (which I thought was a little lean to say the least).

    A couple weeks later, I got a check for $3900.00.

    ‘WTH?!’ [I thought]

    I told my adjuster I refused to even send the check to my Mortgage company and asked them to re-evaluate the claim as my lowest estimate for repairing the roof was in the $8k range (if my neighbor, a professional roofing contractor and myself did the work for free, which isn’t going to happen anyway)…not to mention a $3500.00 heat pump and the shed and my kids’ property…

    Now, I live in a house with no AC/Heat, a leaky roof, and nowhere for my kids to go blow off steam…Also, I am the proud owner of a bunch of useless rusty tools. Finally, there has now been additional damage to the contents of my home as a result of the unrepaired leaky roof…

    I know some of this is my fault for not staying on top of things, but honestly I was so disgusted with the way MY insurance company had treated me, that I didn’t even want to deal with it and I just kept putting it off.

    At this point, is there any way to get my roof replaced and get this depreciation issue solved? I have [at my claim adjusters request] returned the original [now useless/expired] checks [voided] to the insurer with a letter explaining why they were never used…I fear I may already have run out of time to pursue this as it has been over a year since the original date of loss. However I KNOW I’m not the only homeowner in my neighborhood that is still struggling with unpaid/underpaid claims as a result of that freak storm.

    Again Thank you for any help!

    -JCLII -Phoenix, AZ.

  1047. December 29th, 2011 at 10:34 am #Jason

    James,
    In summary, from what you posted, is that you will be able to get that $3900 back from the insurance company. Ir you worked in insurance, you should know this. Insurance changes very little over time so none of this is new.

    A replacement policy is one that pays you up front for the ACV and then when you REPLACE the damaged items or materials, then you make a request for the difference between the ACV and the replacement and then you will be paid that.

    There are time limitations on this entire process and if you are over a year, the best you can do is ask for your $3900 back and that is all.

  1048. December 30th, 2011 at 7:54 pm #James Longwell

    Jason,

    Thanks for your help.

    I DID work in insurance and in fact, was a licensed agent for P&C in all 50 states at the time [2000-2002]. I did not ever work in claims or underwriting; my job was to sell new policies. If I was aware that the company I represented would eventually damage the relationships I worked so hard to establish by not living up to the spirit in which the product was represented, I would never have taken the job in the first place…and they say salesmen are without scruples…WOW!

    I let my licenses lapse…because the insurance industry to me is reminescent of an organized crime syndicate…

    I shall take your advice to heart and next time I won’t allow my disgust to mutate into procrastination.

    Again, THANKS and I hope all the crazies out there are right about 2012 … in my opinion, the best thing that could happen to the insurance industry is an apocalypse… [tee-hee] Happy New Year!

    -James

  1049. December 30th, 2011 at 9:24 pm #Jason

    James,
    Sure, it may be similar to organized crime and the gambling and gaming industry but its income and profits are great in the entire industry since insurance companies originally started and they even have had record years in the recession/depression the country has been in recently.

  1050. December 31st, 2011 at 2:12 pm #juan

    can your insurance deny your fire claim because it was not your prime marry home i got 3 home a i have home owners insurance in all of them

  1051. December 31st, 2011 at 2:21 pm #Jason

    Juan,
    We highly doubt the reason for denial of your claim is because it’s not your primary residence. No, that is not a valid reason for denial of a fire claim. You might want to determine the real reason for denial because no insurance company would deny coverage for that reason.

  1052. December 31st, 2011 at 7:28 pm #juan thanks

    when a policy has 125 % endorsement and my policy covers 125000 thousand
    dose that mean i got 150000 more coverage

  1053. December 31st, 2011 at 7:45 pm #Jason

    Juan,
    No, it means your policy covers up to a little over 156,000 total.

  1054. January 1st, 2012 at 11:31 am #juan thanks

    my home went up in flames an the insurance has not gave me any money to board i am staing in a garage want can i do to get some money or to get paid and it been 8 weeks all ready they said they sen a check but i have not received any thing

  1055. January 1st, 2012 at 12:42 pm #Jason

    Juan,
    Call your insurance company and get things figured out with them.

  1056. January 1st, 2012 at 1:35 pm #justme222

    Juan,

    put your number on here so I can call you or send me your e-mail address so I can possibly help you out, because if what you are saying is true you need a lawyer to hold your insurance company responsible for their actions.

  1057. January 1st, 2012 at 10:25 pm #Enrique

    If you have a ongoing loan modification. Does the bank give you a hard time getting the settlement money from them after you deposit and endorse it to your mortgager?
    Do they require a license contructor to fix the job. What happens if i have somebody to fix the house. The reason for this is not to  have an out of pocket expense for hiring a lisenced contructor.  Is there a justifiable ways to do that. Even if the bank  send an inspector to check the job?? No problem with me, just need to fix it the house..

  1058. January 1st, 2012 at 10:41 pm #Jason

    Enrique,
    We don’t address bank or financing questions in this insurance forum. Discuss your concerns with your bank or mortgage holder if you want to gather information.

  1059. January 1st, 2012 at 10:56 pm #Charlene

    Jason,

    We are finally summing our claim up and recently after questioning our adjuster I did find out that the extra costs of my utilities that were related to the vast drying equipment (water mitigation, and sheet rock mud drying) etc was reimbursable. With additional extra costs in mind are the trips needed to meet with the contractor and adjuster during this 8 month ordeal so are these expenses for my mileage and or simply gas consumed also ones that can be submitted? My adjuster is evidently out on vacation and is unreachable to question him on this. The claim occurred at our vacation home in Yelm which is located a good hour and a half away from our residence in Seattle.
    Thanks by the way for your ongoing help, it has proven to be very reassuring to me at various stages with this whole experience.
    Charlene

  1060. January 1st, 2012 at 11:05 pm #Jason

    Charlene,
    Generally, these trips, mileage, and/or fuel expenses are over-looked or not covered by adjusters. If you happen to get an adjuster that will reimburse for it, present the bills, expenses, or mileage. Sure, the extra electrical expense should be reimbursed but not all adjusters will go out of their way to reimburse for trips, mileage, travel, and all that to complete, coordinate, and supervise a claim.

  1061. January 3rd, 2012 at 6:42 am #Gene

    Two weeks ago, my ex-husbands house that I once lived in (my name is on the deed until he pays my off) burned 70% down. Not a total loss. Just four days prior to the fire, I took my name off the policy because he was becoming behind on the payments. I did not want to be responsible for the delinquint payments. When I inquired on doing this, I was assured there would not be a check written out for any fire or property loss, the insurance company would rebuild and replace. Find, I thought.
    Well, the fire most likely started from a marijuana grow in the attic. And, even if that be the final cause of fire, they are still paying for the rebuild.
    I have a lien against the house.
    Is there some way I can file a garnishment against the proceeds of the insurance claim? Can I file a write of execution, ordering the house insurance company to pay the money to the court? I have heard through a good source he plans on trying to use some of the insurance money to pay debts off.
    I appreciate any information on this.

  1062. January 3rd, 2012 at 7:20 am #Jason

    Gene,
    There is no way you can file a garnishment against the insurance proceeds. Sure you could have planned for this and secured a judgment and with perfect planning and timing, you could have garnished the proceeds but at this point in time, it’s impossible.

    No, you cannot file a writ of execution. (See the above paragraph)

    That is goof if he can pay off some debts and rebuild the damaged house.

  1063. January 3rd, 2012 at 7:34 am #Gene

    To make sure I understand you correctly, it would be “good” for him to pay off some debt with the money? Will the insurance company most likely write him out a check for the loss of personal property?
    I appreciate your prompt reply.

  1064. January 3rd, 2012 at 8:59 am #Jason

    Gene,
    If he pays down debt, that is better than going to the casino and gambling it away – at least in my opinion. He will have reduced some debt by paying it off rather than squandering it away.

    Yes, he will receive a check for the personal property damaged in the amount of ACV. If and when he replaces the personal property, he can make a claim for the replacement cost. The personal property and the entire claim concerning structural damage should not be of any concern to you. You only have an interest in the structural property because you have your name on the deed. That is where your interest ends. You removed any remaining interest in the structure when you removed your name from the policy. You don’t have your name on any of the personal property. What he does with the funds earmarked for personal property is none of your or my business.

  1065. January 3rd, 2012 at 9:47 am #Kate

    I have a tree that is in between my house and our neighbors house. The tree has damaged both properties. I am not sure if the tree is all on my property or partially on theirs. My insurance company said there is a clause that states they are not liable for any damages due to pushing or growth of a tree. Is there any thing I can do? Will I be liable for the damages to the neighbors house, removal of the tree? Can my insurance company be sued?

    Thank you very much

  1066. January 3rd, 2012 at 4:26 pm #Susan

    I co-owned a home with my ex-husband. Mortgage was left in my name as well as his, but he changed the insurance to exclude my name. After this happened the house was completely destroyed by fire.

    My name was on the deed as well as the mortgage. Is their any recourse I have regarding the insurance pay-out on the home other than them paying the mortgage?

    The insurance company already paid him in full on the policy

  1067. January 3rd, 2012 at 5:16 pm #Jason

    Susan,
    You have no involvement is this claim or what happens with the insurance proceeds.

  1068. January 3rd, 2012 at 5:58 pm #Jason

    Kate,
    If there is a problem tree and you know it’s causing damage to your home and that of your neighbor’s, your inaction to prevent more damage is not something you should allow the tree to do to your property.

    When it comes to your neighbor’s property, if you are currently aware the tree will cause more damage to their property and you do nothing or don’t do what a reasonable and prudent person would do to prevent additional damage, yes, you could be liable for future or continued damage.

    Hire someone licensed, insured, and qualified to take out the tree without causing any damage.

    You ask if your insurance company can be sued. Do you mean over your failure to prevent damage? Do you mean your neighbor suing them or you suing them? Regardless, there is nothing to sue them about. They have no say in what you do or do not do so it wouldn’t make sense for anyone to sue them concerning a tree.

  1069. January 3rd, 2012 at 6:33 pm #justme222

    Gene,

    If you got a lien on the house, all you have to do is contact the insurance company and let them know and they will add your name to the check for the structure only. Normally insurance companies check for liens and add the name to the structure check anyway.

  1070. January 3rd, 2012 at 6:47 pm #Karen Richardson

    My daughter’s townhome was burned recently. She was renting it. Apparently the townhome behind her was owned and lived in by the homeowner and he hired a handyman…unlicensed plumber to work on the outside hosebib..it was leaking and he needed it replaced. The plumber torched it off and sauldered a new one back on…but according to the fire cheif he did not use a fire shield and the insulation in the walls caught fire and burned both units down. My daughter had just moved in and had not bought renters insurance. Does she have a claim against the homeowner, or her landlords insurance? Or both? Thanks

  1071. January 3rd, 2012 at 9:00 pm #Jason

    Gene,
    I’m sorry but the advice you received about contacting the insurance company and asking them to place a your name on the check because you are a lien holder will not be honored by the insurance company. Insurance companies don’t check for liens as any step of the process before issuing checks.

    The information must be confused with a mortgage holder because insurance companies will add the mortgage holder to a check prior to issuing a check but because of the subordinate status of a lien holder, they don’t do that. I’m sorry about any inconvenience this may have caused you.

  1072. January 3rd, 2012 at 9:28 pm #Jason

    Karen,
    The landlord or the homeowner likely would not have any liability. The person that would have negligence or the liability for the damage is the unlicensed handyman. It’s very unlikely he hand insurance if he is unlicensed. Renters insurance is what she needed. She will have to get through this loss without the assistance of insurance.

  1073. January 5th, 2012 at 1:51 pm #Karen Richardson

    Jason: Even if the homeowner knew the plumber did not have insurance and he was required by the HOA to carry insurance incase he caused damage to the other units?

    My daughter’s townhome was burned recently. She was renting it. Apparently the townhome behind her was owned and lived in by the homeowner and he hired a handyman…unlicensed plumber to work on the outside hosebib..it was leaking and he needed it replaced. The plumber torched it off and sauldered a new one back on…but according to the fire cheif he did not use a fire shield and the insulation in the walls caught fire and burned both units down. My daughter had just moved in and had not bought renters insurance. Does she have a claim against the homeowner, or her landlords insurance? Or both? Thanks

    answer:The landlord or the homeowner likely would not have any liability. The person that would have negligence or the liability for the damage is the unlicensed handyman. It’s very unlikely he hand insurance if he is unlicensed. Renters insurance is what she needed. She will have to get through this loss without the assistance of insurance

  1074. January 5th, 2012 at 2:56 pm #Jason

    Karen,
    You have to focus on “what did the homeowner do negligently? He hired someone to do a repair to the unit. Hiring someone doesn’t meet the threshold of being negligent for damage the hired person does.

    What if the homeowner hired the handyman without knowing he wasn’t insured and this happened? The homeowner would not be negligent.

    What if the homeowner hired the handyman knowing the handyman was not insured and this happened? That still doesn’t make the homeowner negligent for the fire that damaged your daughter’s property.

    The homeowner is negligent for hiring someone without insurance. That is where his negligence ends. The handyman did not properly do the job he was hired for because it’s obvious – he burned the property. The handyman is negligent for the damage.

    Proving what someone knows or doesn’t know (that the handyman was not insured) is next to impossible. Let’s just say you sue the homeowner and he confesses and says, “yes, I hired this guy knowing he didn’t have insurance.”. Well, now you have proof that he hired this guy without insurance. That still doesn’t make him negligent for burning your daughter’s property. The only thing the homeowner is negligent for is hiring someone that didn’t have insurance.

    If there is a requirement of the HOA that requires a contractor to have insurance, then the failure of the handyman to have insurance puts him in violations of the HOA.

  1075. January 6th, 2012 at 9:24 am #justme222

    Gene,

    the purpose of a lien is to protect your interest in the property. i have witnessed first hand when an insurance company will put your name on a property because you have a lien on it. That is the whole purpose. what would make anybody think they would pay the house off and not protect your interest. people need to learn how to be quite when they don’t know what they are talking about. i would hope that you listened and then post results. Good Luck!!!

  1076. January 6th, 2012 at 2:06 pm #Patricia Aguianga

    Farmers denied our Landlord claim. Tenats left the home flilty to say the least. carpets are FULL of pets’ urine(dogs and cat). Tehre is water damage on teh roof in the bathroom. Tenants burned oil in the kitchen and apparently teh grease went to the carpets, beacuse even after professioanlly cleaning them , they are still very VERY dirty. The adjuster said this was “wear and tear” and as much as he lamented the pet damage to our carpet, he said that is excluded in teh policy. Is there anything we can do.?. Replacing the carpet in teh whole house will be close to $10,000(it is a multilevel condo…lots of carpeted stairs).

  1077. January 6th, 2012 at 7:29 pm #Nicolette

    I just want to say that your responses are very informative and this seems to be the right place for me to ask my question: We received a check for our damage from USAA. The mortgage company (PHFA) was listed on the check; however, I didn’t know that I had to endorse it and send it to them. I mistakenly deposited the check in my account and already went through with the services to fix our basement. It’s all done and the claim is complete. I noticed (and confirmed with an agent) that we will be receiving another check. When I asked them what it was for, they said we get two payments and to endorse it and send to our mortgage company. It all made sense to me after I hung up the phone. I tried calling my mortgage company to ask them if we have to pay THEM any money since we forgot to send them the check. I’m awaiting their callback but I’m very nervous for not following instructions on a $8,000 dollar mistake. I gave USAA all the receipts of work done. It is now the weekend and I’m curious as to what they will say. Will we have to pay for anything out of pocket with all services done?

  1078. January 6th, 2012 at 7:58 pm #Jason

    Gene,
    No, there is reason for an insurance company to name a lien holder on a check issued for a claim. Just like they don’t search for lien holders prior to issuing a check, they also have no obligation to protect any lien holder’s interests.

    It appears justme222 is confused about a lien holder being listed on a check because that is not a practice that any insurance company would want to become involved with. The insurance company has a contractual obligation to the policyholder and the mortgagee, if there is one. In fact this is what a typical policy’s wording is concerning a mortgage and what it will do if there is one or more mortgagees listed:

    K. Mortgage Clause
    1. If a mortgagee is named in this policy, any loss payable under Coverage A or B will be paid to the mortgagee and you, as interests appear. If more than one mortgagee is named, the order of payment will be the same as the order of precedence of the mortgages.

    A mortgagee IS NOT the same as a lien holder and the insurance company isn’t concerned with lien holders and will not add a lien holder’s name no matter how much you insist. I again apologize for the misguided and conflicting information you have received on here.

  1079. January 6th, 2012 at 8:09 pm #Jason

    Patricia,
    No, the condition your tenants left the apartment is wear and tear and nothing else. Some people contribute to more wear and tear than others. These people seemed to have caused a lot of wear and tear.

    You ask if there is anything you can do? You can prohibit tenants to have dogs or cats unless they pay an additional security deposit. If you haven’t retained the tenants security deposit, you might be justified in doing so but only if your rental contract with them prohibited them from wear and tear.

    It is very likely damage to the property by domestic animals is excluded in your policy. The damage the animals did also falls under wear and tear too. Some animals, and their lack of care and training, causes more wear than others.

  1080. January 6th, 2012 at 8:55 pm #Jason

    Nocolette,
    The only reason your mortgage holder is involved in the process of your claim and any damage to your house is because they use your house and it’s value to back the home loan you have. They merely want to make sure the collateral value of the home is brought back up to the pre-loss condition.

    Since it appears you took care of it without involving your mortgagee, there should be no problems. Their only involvement is to make sure you get the repairs done. Since you did, everything is fine and you shouldn’t worry about it.

    You won’t have to pay your mortgage company anything. They don’t want your claim money. They just want the damage repaired.

  1081. January 8th, 2012 at 12:28 pm #M. James

    We are insured by a small mutual insurance company. We have replacement coverage with $189,000 building, $113,000 contents and 12 months actual increased living/loss of rent. Our house was built in 1900.

    We had a house fire in December. It started in the unfinished basement and went almost everywhere. It sounds like the plan is to rip everything to the studs, backspray to seal the smell in, and remodel. This would include windows, doors, insulation, electrical, plumbing, drywall, paint, etc.. The insurance company brought out a cleaning company. We have recorded and tossed all the contents and are doing research on them know. We should be receiving most of the quotes for the building this week.

    This cleaning company had a larger fire renovation company come out to help him do the estimate. The large fire restorer will do the backspraying. He was confident it would be a total loss because of removing the walls with lead paint and such. I asked the large restorer for a copy of the estimate and he didn’t answer. The small cleaner says I shouldn’t even see it (I know that’s wrong).

    #1) Does “backspraying” on the studs actually seal in the smell? I’m afraid to do this kind of work and still have a smell.

    #2) Would a total loss be advantageous to me? Should I pursue this fire restorer more to get that estimate?

    #3) It seems like they are using the large fire restoration company to give a big estimate, then my cleaning guy will give a smaller estimate and go ahead. I am making him use my contractor, plumber and electrician after much discussion. He doesn’t want me to see the bids from the subs but they know to give them to me. Does it sound like I’m being setup for something here? What would you recommend?

  1082. January 8th, 2012 at 2:53 pm #Jason

    M. James,
    In what state did this fire occur? If you live in a state that has valued policy laws, the policy limit is paid if the damage exceeds a certain percentage of the property value. We don’t know what state you live in so we are unable to provide this information.

    Sealing in the smell which is called different names depending in what part of the country you are in does seal in the odor.

    You should have an estimate for every single thing that gets repaired concerning your home. If they are reluctant to provide you with an estimate or estimates, you should be reluctant to have them do any work on your home.

    We don’t know what their intent is.

  1083. January 8th, 2012 at 3:03 pm #M. James

    Jason,

    The state is Minnesota.

  1084. January 8th, 2012 at 3:37 pm #Jason

    M. James,
    Minnesota is a valued policy state. If the damage exceeds a certain percentage of your home, then the insurance company should be paying you your policy limits. However, if they are going to tear down to the studs, it may not meet this criteria.

    Look up valued policy laws because it defines total losses to dwellings and for the most part, and as intended, this legislation benefits the homeowner. For example, if your home can technically be rebuilt from the foundation up for $135,000, it would be in the insurance company’s interest to rebuild it for $135,000. The alternative would be paying you $189,000 to settle your claim and their obligation.

    The above information is only an example and we do not know if your home is a total loss. However, you may want to look into it if it might be.

    If you want, you may sent some photos to our e-mail at the top right of this page in orange letters that starts with “complete…”. Total loss fires are fairly obvious.

  1085. January 8th, 2012 at 4:57 pm #Debbie Mullaney

    Please help! We had an insured storage building that was recently destroyed by fire. It was packed with “stuff” that we valued senimentally. For example, my Barbies from the early 1960’s, along with our children’s toys were kept in there. We also stored our summer wardrobe in the building. My question – How in the world do I begin to itemize when I don’t know how many dolls, shorts, tops, etc…. were in there?

  1086. January 9th, 2012 at 8:41 am #Jason

    Debbie,
    You just have to itemize the best you can. You will have to go there and do the best you can with the remains of the items.

  1087. January 9th, 2012 at 2:43 pm #Ric

    Water damage check:
    I recieved a check from the insurance company for the water damage. The bank need to have a contructors estimate(need licence, sss,etc). The problem is I want to hire a handyman. Of course most of them dont have the buss lisence. But i know this person. Is there a way to hire him instead of those expensive contructors. I’m willing to send all neccesary receipt to prove that im going to put all the money to house.

    Please help

  1088. January 9th, 2012 at 2:53 pm #Jason

    Ric,
    You will have to take up that with your bank. It’s not an insurance question. It’s a mortgage holder (bank) question.

  1089. January 9th, 2012 at 4:24 pm #juan

    I have a fire claim its been more than 2 month the insurance ask me to take a interview under oath i been waiting to do this intervew its been more than 3 weeks an now they are not returning my calls what can i do to hurry up this prosses

  1090. January 9th, 2012 at 4:52 pm #Jason

    Juan,
    Rather than leaving a message and waiting for someone to call you back. Stay on the phone until you get some answers. Do you know when the EUO is set for?

    This is a long time into a fire loss to be conducting these interviews. Why is it taking so long? What is the fire investigators conclusion concerning how the fire started?

  1091. January 9th, 2012 at 6:43 pm #juan

    the fire was arson but they are saying that they now wee wernt involve but they want to do more investigation on it how much investigation can they do i am living in a garage becuase they have not gave me a home and the only money i got from them is 1000 dollers i have don every thing they want. they toll me this is the last step but its been 3 weeks and i have not herd from them i just dot know what els i could do

  1092. January 10th, 2012 at 10:26 am #juan

    what is a s-I-u investigation

  1093. January 10th, 2012 at 4:18 pm #Jason

    Juan,
    SIU investigation is stands for special investigation unit. If you were not involved, they should be paying your claim and continuing to investigate while they settle your claim. You may need to seek the help from a public adjuster or someone that can assist you in getting this going. Nobody should have to live in a garage.

  1094. January 10th, 2012 at 5:06 pm #juan

    is it to late to get a public adjuster i got one more intervew under oath an a public adjuster will take 10% of the hole claim, and if i get one will this prosses go faster

  1095. January 10th, 2012 at 6:03 pm #Jason

    Juan,
    You have to make the best decisions for yourself and only you know what those are. If you obtain a competent public adjuster, it should proceed faster but that is all based on the public adjuster you obtain.

    Any good public adjuster is going to maximize your claim to justify having them there. That doesn’t mean there are also public adjusters that are on good.

    However, since this is a fire and I’m going to assume a total loss. Let’s just say the loss is $100,000 and if that is what you are going to be paid and the public adjuster does nothing for you. Absolutely nothing – you still will have to pay him $10,000.

  1096. January 10th, 2012 at 7:04 pm #Brad

    Is it legal to profit from an insurance claim? The work needed to be performed as specified on the insurance loss sheet isn’t nearly as much as the insurance company has allowed. Is this committing fraud?

  1097. January 10th, 2012 at 10:39 pm #justme222

    Juan…..get a lawyer

    Brad…..No

  1098. January 10th, 2012 at 10:43 pm #justme222

    Ric, depending upon what state you live in you can pull a homeowners permit and do the work yourself (check your local laws on this first). Just be careful about saying you are paying someone to do the work. The bank or noone else can tell you who you have to hire to do your work.

  1099. January 11th, 2012 at 3:57 pm #Jason

    Brad,
    Part of doing a construction repair involves materials, labor, professional insurance, book keeping, profit, and payment of taxes. Some jobs allow more in profit than others. If you are able to efficiently repair the damage and make more profit, that is called capitalism and that is how our country operates.

    The insurance company wrote the estimate, not you. It’s a kind of “take it or leave it” scenario. If you don’t want to do it, just let someone else. If you wrote the estimate, it would not be for as much money.

  1100. January 11th, 2012 at 4:09 pm #Jason

    Justme222,
    Could you tell us just one state that requires a homeowners’ permit? That doesn’t make any sense. Does that mean they need a permit to be a homeowner? Thanks.

    What you are saying is for the homeowner to mislead the municipality or state concerning a required permit by withholding the unlicensed contractor who will be doing the work. I think it is reasonable if we keep our responses to ones that are legally permitted and above board. We all need to maintain a degree of integrity in any post that we provide and I won’t condone that suggestion in the least.

  1101. January 11th, 2012 at 8:37 pm #justme222

    Jason,

    You dropped the ball again: o.k., first of all you must don’t know what a homeowners permit is. So, let me help you out. A homeowners permit allows the homeowner to do the work themselves, but it will still be inspected by the city to make sure the work is done according to code. So, to answer your question with a question: What State would not require a homeowners permit?….HELLO!!! Tell me what State would let you just build and don’t inspect…..HELLO!!! Maybe next time you open your big mouth about something you don’t know about you should do your research. Maybe if you do your research and quit getting smart with people and just answer the questions humbly and kindly you would get more donations, because obviosly you need them. Shame on you for taking advantage of people who are already at a disadvantage with their insurance companies. Google “homeowners permit” and learn. The sooner you humble yourself, the better off you will be.

    Sincerely,

    Justme222

  1102. January 12th, 2012 at 3:01 pm #Observer

    Justme222

    I just have to say I admire you! Jason is cocky, and incorrect half the time. People come here get help, most of the time when people need help they would like it told to them in a decent fashion, not some smart fashion. I personally asked a question several months back, Jason told me it wasnt covered, and guess what!!! I sure was! I agree, maybe if he took a little time to be nice, folks in return would do the same in the form of a donation.
    Again, thanks Justme222 for saying what most people are thinking.

  1103. January 12th, 2012 at 4:46 pm #Jason

    Justme222,
    I have to apologize that you used the wrong terminology. It is a “building permit” or a “construction permit”. There is no such thing as a homeowners permit. Just try to be a little more accurate next time.

    It is important to use the correct words to guide someone so they are not left more confused before they submitted the question.

    And the main thing about your previous suggestion is that you should not encourage people to circumvent the codes, regulations, and laws about anything. Why didn’t you address the part about your answer not “being legally permitted and above board”?

    p.s. Also, Justme222, that sure is a nice post you made as “Observer”.

  1104. January 12th, 2012 at 5:52 pm #observer

    Hate to burst your bubble Jason, just Justme222 didn’t post my comment. And FYI here is a “homeowner permit” since you’ve never heard of it. This is from Austin Texas: Homeowner’s Permit
    A person who is not licensed to perform electrical, mechanical & plumbing work may perform within a residence and on property owned by the person if the requirements of this section are met

  1105. January 12th, 2012 at 5:55 pm #observer

    The entire link: keep in mind this is for Austin Texas.
    http://www.ci.austin.tx.us/development/onestop/downloads/permits_homeowners.pdf

  1106. January 12th, 2012 at 6:11 pm #Jason

    Observer,
    Thank you for your input. It is very helpful. Just because that terminology is incorrectly used on that Texas site doesn’t make it a correct term.

    Please use the term construction permit or building permit to describe this so it doesn’t confuse people.

  1107. January 12th, 2012 at 6:41 pm #observer

    Wow, you do know it all! I’m sure you are just not familiar with different terminology. Just so you know, it varies by regions. Just because you have not heard it called that before doesn’t mean it is incorrect.just like state store, liquor store and way down south they call it a package store. Same meaning different word.

  1108. January 12th, 2012 at 7:14 pm #Ponger

    I recently had a sudden major water heater leak. Although my drain pan was working properly the water still overflowed and caused major damage to my kitchen/living room flooring and nearly all the dry wall in my garage. I live in a townhouse with an HOA and when I tried to file a claim with my home insurer they stated that they were only responsible for the laminate flooring and none of the drywall or other damage as it should be covered by my HOA insurance. However, when I look at the HOA CC&R documents it seems to only pertain to common areas. All the damage is in my home. The adjuster claims that it is very common for the HOA insurance to cover the drywalls and paint. But when I contact the HOA they state it’s my private insurer’s problem. Does this sound right? I don’t know what to do now.

  1109. January 12th, 2012 at 7:15 pm #Jason

    Observer,
    If you want to use inappropriate terms, that is up to you. I will provide consistent and accurate terminology because insurance is confusing enough.

    Also, since dialog with you on this insurance forum is not helping others that need insurance help, your posts will now be ignored. I don’t have time discuss meaningless things with you.

  1110. January 12th, 2012 at 7:24 pm #Jason

    Ponger,
    A townhouse has some tricky language that can be a bit confusing as to which policy covers what. When a claim such as yours happens, it is very common for 2 claims to be opened and worked on to get the damage repaired. Much of the time, both insurance companies work together to coordinate what they pay for and what the other insurance company pays for. You should not be this involved in who covers what. You should just report this claim to both insurance companies, pay your deductible, and they should get it all worked out without too much confusion or hassle.

  1111. January 12th, 2012 at 7:31 pm #observer

    Same to you Jason. Keep being close minded.

  1112. January 12th, 2012 at 8:19 pm #justme222

    Jason,

    A construction or building permit is for a licensed contractor. Homeowners permits are for “homeowners” who desire to do their own work. Stop being so hard headed and just google it. You only gain to learn something. You are making yourself look so dumb. This is the perfect opportunity for you to learn and humble thy self at the same time. See, it comes to a point in all our lives where we need to do that.

  1113. January 12th, 2012 at 8:21 pm #justme222

    Observer,

    Thank you very much!!! Jason just needs to humble hisself and quit misleading people.

    Sincerely,

    Justme222

  1114. January 12th, 2012 at 11:49 pm #M. James

    I asked a question earlier on my specific claim, but I do have some more generic questions.

    Let’s say a house is determined to not be a “total loss.” Let’s use, for example, that all the estimates come in at $150,000 and that is below the policy limit. What are my options? I understand them to be:

    A) Go ahead and do the repairs for $150,000
    B) Do the repairs yourself (what happens with the money I’d save?) (I am a licensed contractor)
    C) Tear it down and rebuild onsite for $150,000 and foot the bill for the rest
    D) Do nothing, pay off the mortgage, and pocket the rest, discounted at some undetermined %

    Am I correct in my understanding? Could you clarify.

  1115. January 13th, 2012 at 11:09 am #Jason

    Justme222,

    Sorry, I don’t need to google something when I already know the correct terminology.

    What a homeowner needs to perform work in their home is a building permit. So, if you want to use the word homeowner with the words “building permit”, it would be homeowner’s building permit.

    As I’m mentioned to your other post, observer, I don’t have the time to keep repeating these somewhat simple concepts to you over and over so I won’t be addressing you anymore.

  1116. January 13th, 2012 at 11:15 am #Jason

    M. James,

    All those options are available to you. However, there are some policy conditions that you would have to meet for a couple of them. If you have a replacement policy, you have a certain amount of time to complete the work and then make a supplement claim for the recoverable depreciation. This time frame is base on your policy and 180 days is a standard amount of time allowed in many policies to get the work completed. (Your policy may have a different time frame) You always want to keep this in mind so you don’ paint yourself into a corner with the initial decision you make.

  1117. January 13th, 2012 at 3:08 pm #Denae

    My husband and I just purchased a new home in a short sale transaction. (actually 6 months ago now). We took a video and pictures of the condition of the home during our initial walk through. After we purchased our home owners insurance policy and before we received the keys and walked into our home, the previous owner had stolen many fixtures in the home including a $10K built in refrigerator, every single mirror in the home, fans, many light fixtures and chandeliers. We tried to get him to bring the items back, we have letters back and forth between us and him. We do have pictures of all the items that once existed in the home that he took. He did bring back a couple of the light fixtures, but that is all. We did not file a police report. Can we turn this into our home owners insurance?

  1118. January 13th, 2012 at 3:51 pm #Jason

    Denae,
    This has the air about it of a civil disagreement between the prior owner and you. Especially the part that he brought back some of the light fixtures.

    Of course you can submit a claim with your homeowners insurance. Although it’s got civil disagreement all over it, you might get an adjuster that finds this may be a covered event.

  1119. January 16th, 2012 at 10:03 am #Terry

    About 1 week ago my wife and I heard a loud noise coming from downstairs. I looked and did not see anything. The next morning we found a crack in the kitchen wall, ceiling, floor(tile) and counter top. We also noticed a few doors are no longer square in the jams. Brick on the outside in this area has cracked at the morter lines.We have been experiencing a drought here in Texas and I have been watering my slab weekly. My question is, will my home owners insurance cover this damage? We were not experiencing any problems prior to this “event”.

  1120. January 16th, 2012 at 2:18 pm #Chris

    I had wind damage to my house and received a check for $7,300 from my insurance which was to cover the water damage on the inside, damage to the fence, and replacement of 3 tab shingles. When I have had contractors give me bids, they quote for installing architectural shinlges at $7,400 and not including the other repairs. I am not satisfied with these quotes so I am still shopping around. My Ins. company now is saying that they are going to drop my insurance if I don’t have repairs done expeditiously. Can they do that?

  1121. January 17th, 2012 at 9:03 am #Jason

    Terry,
    We don’t know what happened to your home and if it will be covered by insurance. This is a common part of your policy and it may apply to the situation that happened.

    2. We do not insure, however, for loss:
    c. Caused by:
    (6) Any of the following:
    (f) Settling, shrinking, bulging or expansion, including resultant
    cracking, of bulkheads, pavements, patios, footings,
    foundations, walls, floors, roofs or ceilings;

  1122. January 17th, 2012 at 9:12 am #Jason

    Chris,
    If your home is not in a condition that an insurance company wants to insure, they don’t have to. So, get the repairs completed so you are no dropped.

    If you are soliciting roofing contractors, you may need to solicit a contractor that can repair items on a home and not just one specific item like shingles. Perhaps a general contractor or handyman, or similar would be able to address you concerns instead of a contractor that only does roofs.

  1123. January 17th, 2012 at 1:25 pm #Wilson

    My home was vandelized and when I called my insurance company on the date of the vandelism to file a claim they told me that because I did not file a police report that they would not pay for any damages. They instead offerred me a HELOC. I told them that I would hang up and call the police, get the report, and fax it to them but she said it was too late. Is there anything I can do to file my claim for to report the insurance company to a regulatory agency?

  1124. January 17th, 2012 at 2:36 pm #Jason

    Wilson,
    Are you sure you called the insurance company? If a company is offering you a HELOC, that is a very common term for a “home equity line of credit”. Banks and credit unions offer helocs.

    Why don’t you file a police report because that is the most reasonable thing a homeowner would do after someone vandalizes their home.

    Then, after that is done, call you insurance company, not your bank, and submit a claim for the vandalism that some one did you your home.

  1125. January 18th, 2012 at 4:52 am #Wilson

    Yes, I called the insurance company. My insurer is USAA…they gave me a HELOC (home equity line of credit). They are a bank and an insurance company. Police report was filed.

  1126. January 18th, 2012 at 10:04 am #Jason

    Wilson,
    Now that you filed a police report, will they investigate your claim? If so, then everything is happening as it should.

  1127. January 18th, 2012 at 2:39 pm #Terry

    Jason,
    Thank you for your response, although it’s not what I wanted to hear! There is a fairly large oak tree about 15 feet from where this damage is, possibly causing my problems. If that were the case, would/should my insurance cover these damages?
    Thanks for your help!

    Terry

  1128. January 18th, 2012 at 4:32 pm #lossoffaith

    (Certain identifying info in the following comment has been removed by Admin per the commentator’s later request.)

    I desperately need help and or advise! I had a house fire on xx/xx/2009 after just completing construction only a few months before. I battled with the adjuster over amount of loss for 1 month then hired a public adjuster after deceptive tactics on their part. The original estimate was in the neighborhood of 70,000.00 after a year of estimates going up and then back down then up again my adjuster came to a stand still at $244,000.00 for dwelling repairs and informed me that xxxxxxxx’s stance was not to pay for any further damages. There were items that the adjuster agreed to pay for but when he would not agree to pay supplements needed for a particular repair that prevented that repair to be made he would then remove that item from the estimate and then when my Public adjuster would argue that they still had to pay for replacement cost minus depreciation regardless… he would ad some things back and sometimes raise the depreciation percentage. I could go on and on about the adjuster but as it stands now I invoked the appraisal clause of my policy on xxxxxxxx x, 2011 and immediately hired an appraiser. xxxxxxxx hired an appraiser that after seeing the home had already agreed that more damages were owed and in fact had made the statement that” Nationwide dropped the ball on this one”. My appraisers estimate came to an additional $350,000.00 in damages approx. After about 6 months both appraisers had scheduled to meet to compare their estimates and try to come to a decision on the amount of loss. Only days before their meeting xxxxxxxxx fired their appraiser, hired a second well known (intimidating) appraiser and also then called me in for an EUO. This almost three years into the claim… and requested all emails, documentation between myself and my appraiser, my public adjuster, my contractors and any and all receipts or documentation that pertained to the original pre fire construction of the home as well as all documentation of the post fire construction and gave me a very short time period to obtain that documentation some of which had been destroyed in the fire. It was recommended that I hire an attorney to assist me for the EUO and I did and at his suggestion Myself and my girlfriend arduously worked days and very late nights all the way up until the morning of the EUO and presented everything that they had asked for. Even all emails and all the way down to the original sketches of the home and the blue prints. At the interrogation….I mean EUO I felt bullied and was asked to produce even more documentation that was not obtainable by me at the time. I was given another deadline to present this documentation by December 30,2011. Working with my bank and many more long hours for both me and my girlfriend… and also dealing with the Holidays I presented all the documentation by the deadline. In the mean time… after they fired and hired the new appraiser (investigator) around September 14, 2011…the new appraiser had made no attempt to view the property until the umpire requested a meeting at the house on Nov. 30,2011. At that meeting the new umpire asked me to stay and walk through the house with just him and my appraiser. At that time the NW appointed so called appraiser quoted me from the EUO, told me he was going through all of my emails and the documentation that I submitted. Made statements that indicated he had researched my personal life and then at the end recommended that I come up with an offer to settle and not to B.S. him and he would see what he could do about settling the claim. All of this as I understand is totally inappropriate behavior for a supposedly non biased appraiser. I am 11 days away from the 3 year anniversary at this time and they have made it very clear that they intend on delaying the appraisal process as long as possible. The appraiser has made no attempt to date to come to the house or even begin putting together his estimate. In my opinion he is actually acting as an investigator on behalf of Nationwide and trying to determine some reason as why they should not pay for any damages. I am not sure what to do at this point. There are not many attorneys in this area that are specialized in Insurance law and policy. Both sides have presented a non binding offer to settle. Mine being drastically reduced from the estimate and theirs not even a third of the reduced figure. I think the new appraiser should be disqualified due to his inappropriate behavior and I am also considering a bad faith suit against them and have been urged by some to do so that know all the circumstances. But I’m not sure if I can find an attorney and file it before the statute runs out on the 27th….if I can even find one knowledgeable enough to do so. And to add to it….money is also a factor as just the EUO has drained me financially. What are my chances of finding someone to take this on a contingency basis? Any suggestions would be greatly appreciated and if you know of any attorneys or advisers in the xxxxxxxx area please let me know. And also it may be a crazy question….but could I file a bad faith suit or argue that the appraiser is not non biased myself so that I don’t miss the statute? It has been exactly 1 year and 14 days since I invoked appraisal and they have no estimate to date. Thanks and I look forward to your response.

  1129. January 20th, 2012 at 12:32 pm #admin

    Lossoffaith,

    Most free info blog forums like this are intended for short questions, which are more likely to get answered. Otherwise you should consider getting a UClaim.com insurance claims advice eBook or retaining an expert like Jason (see orange Donations link upper right sidebar) or a public adjuster or a lawyer.

  1130. January 20th, 2012 at 7:11 pm #Jason

    Lossoffaith,
    Your and about 30% of the people I provided information to on this forum will need to be posting a donation amount with their questions. The more detailed the response, the more of a donation that should be offered.

    Lossofaith, your immediate answer is simple but the followup to it is complicated. I receive nearly 50% of questions directly to my complete.insurancehelp.cllaim@gmail e-mail and I will be asking the same donation you are willing to provide for the answers I post regardless when I provide the answer. The alternative is paying an attorney $200/hr. If you haven’t realized, I answer all questions as soon as possible and many time the same day.

  1131. January 22nd, 2012 at 10:13 am #Brook

    I often have standing water covering my foundation footers there is no sign of deterioration or rot but over time if this were to cause problems in the foundation would it be covered, if not do insurance companies have riders for this type of problem?

  1132. January 22nd, 2012 at 10:48 am #observer

    Jason why don’t you just not answer questions any longer since you feel
    Your biased, jerky answers deserve money? Have you stopped and thought that maybe if you weren’t so rude people might just provide a donation to you! Don’t bother answering- I don’t need one. It’s not productive to this blog.

  1133. January 22nd, 2012 at 11:55 am #Jason

    Observer/justme222,

    It’s a business decision. When each donation costs a portion of the proceeds to process, the time and effort to provide timely insurance information to those that need immediate answers doesn’t appear to provide the appropriate benefit to each party necessary when we are talking about large sums of money that can be gained (and in most cases – lost) from having or not having the accurate information in a timely fashion. It can be very costly to blindly and unwittingly deal with the adjusters and insurance companies who will cheat you of your and other people’s claim money.

    This site attracts people, such as yourself, looking for free information unwilling to pay for the valuable information that can be obtained from those of us with the experience, education, and knowledge to help other people. I will have the advantage in making sure my claim experience is as positive as it can be because I know the ins and outs of insurance claims. The ones that will be injured/defrauded/taken advantage of will be the thousands and thousands of people that won’t pay a small sum of money for some priceless advice.

    Regarding the question you posted previously, that I provided you information about, I can assure you it wasn’t covered because 1 of 3 reasons. 1. It was already denied – 2. you described the scenario incorrectly – or 3. you never posted a question. When you provide incorrect information about your claim, it only means you will receive incorrect information as a result. So, please don’t blame me for your communication shortcomings. It’s ok that you won’t identify which question you posed because it’s embarrassing being denied a claim.

    If you want to continue this dialog, you may do so by communicating at complete.insurancehelp@gmail.com.

  1134. January 22nd, 2012 at 2:52 pm #Kari

    Brook- Most insurance policies exclude foundation damage. If you notice the water you may want to have it checked out and fixed before it causes major damages.

  1135. January 22nd, 2012 at 3:22 pm #Keith Davis

    I signed a paper with a public adjuster adjuster stating he can communicate with the insurance company. It was not a contract that stated fees.The public adjuster also pressured me into using his friends dry out company. He also had a construction engineer come in. It seemed that both the dry out company and engineer bills were excessive. This public adjuster used the insurance company proof of loss for my flood damaged house. He refused to file a supplemental claim. He then wanted me to meet with a lawyer and he would be done with my claim and I would pay the lawyer 40%. I refused to use the lawyer and filed a supplemental claim my self and the insurance company was easy to work with. Now the public adjuster wants me to pay 15% to him which comes to close to 18,000.00 dollars. Do I need to pay him? He wants to take me to court and put a lein on my house.

  1136. January 22nd, 2012 at 3:47 pm #Jane

    We had a total loss fire in July. The insurance company just quit paying our rent stating this was a reasonable time. We have not started to rebuild due to weather and also no final plan due to being underinsured and trying to create an equivalent home on a much tighter budget! We were trying to use the household item total to supplement the dwelling cost but w/depreciation this is not looking promising either. What are the best items to submit first…for household goods. Our list will greatly pass the amount we were covered for.

  1137. January 22nd, 2012 at 4:31 pm #Casi-lee

    Hi there! Wonderful, informatve site, thankyou for doing this.My question: We had a hot water heater flood 2 rooms in our home (pressure release valve went) and some mold appeared. The ins co investigated and discovered grade issues n mold in crawl space. They stated that the mold inside was created by this ot the tank. They also have not paid for personal items, drying costs, though we asked over and over.Because we experienced this and lack of updates, calls, lies and a threat on once, we threatened to file suit for bad faith. Now they have reserved their rights again and now say they paid out because the drain pan malfunctioned not the tank (though it states otherwise in the experts report) and wish to come and get the tank for a subrogative investigation (against the tank manufacturer). They were here to test the tank 2 months ago, finding it defective. What if we dont have it available anymore? What happens then..will we be denied? Thanks for your time and God bless!

  1138. January 22nd, 2012 at 4:41 pm #Casi-lee

    What a fantastic, informative site, tks for doing this for us all! My Question: Our hot water fooded two rooms and created some mold. The ins co. investgated & found grade issues, & mold in our crawl space (where the tank drains) and found the tank pressure relief valve faulty. They paid a small amount, excluded mold, our items, drying costs, despit our asking for them to be paid over and over. We have had no updates, return calls, were put off, lied to and threatened on 1 occasion, so we threatened to file suit for bad faith. They now reserved their rights and say they paid because drain the pan failed not the tank (though their experts report states that the tank is faulty)and want to pick up our tank for a subrogative investigation against the tank manufacturer. If the tank isnt available will we be denied. its been 2 mths since they tested it and they never said we had to hold on to it. I wonder if they want the tank so we dont have it for evidence in a trial or to try to blame the failed valve on something other than what they cover. What should we do now? Thanks for your time. God bless!

  1139. January 22nd, 2012 at 8:39 pm #Jason

    Brook,
    No, it would not be covered. Water at or below ground level is included as a common consequence in every policy we are aware of.

  1140. January 22nd, 2012 at 8:46 pm #Jason

    Casi-lee,
    If there is a covered caused of loss such as a leak from a water heater. All the damage that is caused by the leaking water is covered – even the mold. Had it not been for the water escaping from the water heater, there would not be mold and that is the test used to determine what is covered. The only item that isn’t covered is the appliance that water leaked from. If they want the water heater, let them have it so they can attempt to collect from the water heater manufacturer because the item failed and caused the damage. In there collection efforts they will be trying to get your deductible back too.

  1141. January 22nd, 2012 at 8:51 pm #Jason

    Lossoffaith
    Break your post down into paragraphs with related items. I will address your concerns but not in the format that you currently have posted. It’s overwhelming and difficult to read. I am not trying to be mean or anything, it’s just that if I have decipher your post, organize it myself, and the post a reply or replies, I am spending way too much time on a single insurance issue. Thank you.

  1142. January 22nd, 2012 at 9:00 pm #Patrice H.

    Hi. My home was burglarized last week. Stolen items were flat screen, gaming systems, jewelry, cellphone and laptops. My back door (their entry point) has been damaged as well as the lock and the framing around it. The police was called and a report made.

    questions:

    We didnt discover everything missing until days later. The police report only lists a few of the obvious (TV, gaming system, games,broken alarm pads/speakers) will that be a problem with the insurance company/adjuster?

    What should we know before making a “statement” with the insurance company and what should we expect given our situation.

    and finally,

    should I wait for their response before making repairs (specifically to the back door) and the window.

  1143. January 22nd, 2012 at 9:08 pm #Jason

    Admin,
    I have identified inappropriate posts numbered 1102, 1103, 1105, 1107, and 1132. Although I believe in free speech and the open expression of ideas and opinions, those posts cross the line.

    If you want your forum to be contaminated with comments of that sort, please take no action.

    If you want my continued assistance to the people that need insurance advice, guidance, and education, then I will continue to provide that without 1 or 2 people questioning and sabotaging the information I provide to people in a timely manner without any justification to do what the are doing.

  1144. January 22nd, 2012 at 9:17 pm #Jason

    Patrice,
    This is you home. Do you what you need to do to fix it. If you need to take photos of the damaged door, do that. But, fix your door and keep records of the cost of doing that like the estimate or invoice for that.

    Then since you discovered more items stolen, you will need to do a supplement to the police report. The insurance company will not consider anything if it’s not on the police report. Go to the police station and indicate that you need to make a supplement statement to you report and they will assist you with that.

    When you are making a statement to the insurance company, be calm and realize it will be recorded. Be honest about everything. If you don’t know, indicate that. One of the questions you will be asked is if you suspect who did this and why you suspect that.

  1145. January 22nd, 2012 at 9:47 pm #Jason

    Jane,
    We don’t understand your post. We understand you had a fire. We assume you were paid the ACV portion of your claim and that is basically a down payment to get the work started. When the work is completed, you may make a claim for the recoverable depreciation. There are time limits to getting the work done. The insurance company time frame is written in your contract and it is usually 180 days. If you go past your policy time limit, you don’t get to claim the recoverable depreciation.

    If you had a fire in July, that is basically 6 months until the present day and contractually that is the probably the amount of time you had to rebuild. Weather is no excuse when it comes to building. There are ways to get around building by placing a prefabricated house on the foundation after the debris is removed, for example.

    Without knowing your specific details, the amount of money you have already received is probably the entire amount you will see concerning your entire claim including the contents and the dwelling.

    We cannot provide you any positive information. If you would have written immediately after the fire occurred, we could have explained the entire process to you and guided you though the time limits and process that you had before you.

    The only thing we can think of for you to do do is to ask the insurance adjuster to make an exception to allow you an extra 60 days beyond the total limit allowed in your policy. If he can make that exception, you will need to rush like there is no tomorrow. But don’t count on him allowing you that extra time. If there was a death in the family or some severe delay to you rebuilding, bring that up as a extraordinary issue that delayed your entire claim.

  1146. January 22nd, 2012 at 10:26 pm #justme222

    Jason,

    Why are you talking to me when I didn’t ask you nothing. When “observer” speaks to you then address him. You are really nothing to me but a lonely old man so do what you said you would and stop talking to me cause you dumb and not even close to being on my level.

  1147. January 23rd, 2012 at 2:55 am #admin

    Observer, Justme222 and Jason,

    I’m not inclined to delete the comments Jason asked for because there is no profanity or social discrimination in Observer or Justme222 comments. To me it is just passionate freedom of speech, professional or not.

    Jason may appear to be pro-insurer at times, but considering his background, to my knowledge, of having only been employed by insurers, he IS extremely open minded. In other words, he is not one of those wanna be hero adjuster types who would screw a little old lady for a pat on the back from his claim manager. For those few of us who have had to earn a living working in insurance claims, both for AND against the insurance industry, try to remember how one sided most of us were when we worked only for insurers, against consumers.

    As to Jason’s condescending demeanor at times, can we cut him a little slack for being human? It’s hard not to feel insulted when visitors post big dollar questions with no regard to spelling and grammar. Jason has, after all, generously given an enormous amount of his time to this website and received little (if any?) compensation in the way of donations or just plain thanks. That alone should say where his heart is.

    For the record, Jason does know what it feels like to be screwed by an insurer, but he is very private about it. Maybe that’s why he donates his time here?

    Disagree all you like with Jason. And educate him and all of us. But please try not to be so harsh on Jason. 🙂

  1148. January 23rd, 2012 at 4:52 am #observer

    Jason- I’m sorry but you are wrong again. Both of my claims were covered, the first was a water claim, to which you said it was maintenance which the claim supervisor once involved agreed it wasn’t and paid over $2,500- and my second claim was hail damage that was covered to the tune of $19000. So no, neither claims was denied.

    Admin- thank you for see my posts for what they are and not deleting them. With your explanation regarding Jason’s bad claims experience, I can now see why he can be so condescending. Although I am afraid people will turn away from your wonderful blog should he continue to demand donations, and act in such a holier than thou manner.

  1149. January 23rd, 2012 at 7:34 am #Jason

    Osberver,
    Which # is your post so I can learn from my mistake? I many not have read it correctly or didn’t have enough information when I provided the information.

    Hail is a covered cause of loss and I don’t know of any way a hail claim would be denied unless the “hail marks” were caused by a ball peen hammer which I have personally seen on several occasions. If you want to give me credit for saying your hail claim would be denied, make sure you make that clear, ok?

  1150. January 23rd, 2012 at 8:04 am #Barbara

    Question:
    Should I contact my insurance company about a claim? Will I have to pay the $1000 deductable more than once? What are my steps to take? I am very confused and lost and have heard such conflicting information.
    Background:
    We bought the house 4/2009. By 6/2009 we had a major hailstorm and we had the roof replaced. Insurance paid for this. 🙂 Never noticed a problem. For those of you know anything about TX we have been in a drought for a while. Recently we started having some rain. I have no idea for how long damage has been visable. Reasons: teenage boys room, behind the door and there was a tall bookshelf there. Was discovered when they found puddles of water on the floor. After further inspection this has been occuring for a while. So to my knowledge the drywall in the ceiling, and wall will need to be replaced, the door jam, the baseboards, the laminate flooring, the wood finish outside. It is a guess but the insulation, and the frame/ studs in that area.
    We had a roofer come who said that we would have to pay two $1000 deductable one for the roof repairs and one for the wall repairs. he said that the roof repairs are not likely to come to much more than$1000. He also said that the insurance company is likely to deny this claim for the wall repair? Is that so? If so why? He said that we will then have our rates raised yet still have to pay for the repairs. Insurance may even drop us. We do not have Mold coverage in our insurance either.
    So my above questions: What do I do? To come up with a $1000 we will have to get a loan for that. So we cannot afford the repairs. No furniture outside of a bookshelf ere damaged. not seeking that just seeking repairs of the home. What do I do next? To save costs I am willing to do the de-construction and clean up. As mentioned I do think this leak may have been going on for a while just took a steady amount of rain for it to come into the house where I saw it. I am not seeking medical claims as we are not really suffering from mold problems.
    thank you,
    Desperate in Texas Barbara

  1151. January 23rd, 2012 at 8:25 am #Jason

    Barbara,
    If the damage will not exceed your deductible, there would be no reason to make a claim for it. Just fix it. The insurance would never know and your premiums would not go up because of a claim you never submitted.

    The question that comes to mind is did the roofer who put the roof on do it correctly? The roofer should be called to make sure he did not do something incorrectly because this all started happening after the new roof was put on, right?

  1152. January 23rd, 2012 at 8:40 am #Barbara

    you really think repairing the roof from where the flashing was done wrong, the outside wall the wood siding is damaged, the drywall in several areas, door jam, flooring, baseboards need to be replaced. I have No idea about inside the wall, will cost under $1000? I am assuming that there is damage there as well if I can see this outside of the wall. I am just concerned. So you think we should pay for this ourselves? I guess I need to get a contractor in for an estimate. My concern is that I may not be able to hire the contractor for a while as I am broke. I am scared to contact the insurance company have heard so many horror stories about it. Thank you in advance.

  1153. January 23rd, 2012 at 9:40 am #Jason

    Admin,
    Since the beginning of the year, I have posted 47 home claim posts, 34 auto claim posts, 22 denied claim posts, 15 claim law posts, 4 general insurance posts, and 2 business claim posts for a total of 122 valuable and timely insurance responses.

    Justme222 has posted 10 responses in January with as much information as she is capable of providing.

    Observer has posted 6 responses in the month of January and in one she indicated I “was wrong half the time”. Admin, If you want to promote that kind of obviously incorrect information on your site (in post 1103) which we all know is incorrect, then that is your choice because this is your site. I generally accept incorrect information with a grain of salt but when a statement such as that is left on your site without a comment to the contrary, my impression is that that others will read it and believe that. If that is the case, then my credibility suffers and if people believe that half the information I provide on this site is wrong, then I should stop posting on this site because half my information is wrong, or it is perceived to be wrong.

    The real tragedy is to let someone make an unfounded and unsupported statement like the one I have referenced without any support

    I was a little harsh when I mentioned the other posts should go and I change my position on all but one of those posts. I am certain I am justified in requesting that post 1103 should either be supported by including 50% of the posts that I submitted are wrong or post 1103 should be deleted.

  1154. January 23rd, 2012 at 10:57 am #Angie

    My house (chicago, Il) was damaged by a storm (the area was actually considered a catastrophy area by the state) back in the summer. It hit my hard very hard and my basement flooded. I had my insurance send an adjuster. They pretty much do not want to consider any of the exterior damages. This was about a month ago. I asked if they can send another adjuster and they denied me. Is that even legal in the state of illinois? To make matters worse, last night all the snow defrosted and part of my roof has a huge crack and it looks like it’s going to cave in. I called them and told them about the situation and they pretty much did not want to send another adjuster. What should I do?

  1155. January 23rd, 2012 at 11:42 am #Observer

    Jason,
    I think you are being petty. We all can see how much you contribute, but for you to say with absolute certainly that myself and Justme are incorrect with what we post is just not correct. It appears that you refuse to take any one elses view on anything. Even after the link for the “homeowner permit” was posted, you continued to say it was wrong and that if I wanted to continue to use it inappropriately….When in fact it wasn’t. It was just something that you hadn’t heard of.

    So if anyone should be concerned, you are correct, the page owner should be that the banter and condescending responses may drive people away.
    It is very inappropriate to demand donations, for you volunteering your time on this page. If you feel the response takes too much effort then by pass it. I am pretty sure that most people on this page know that it’s a “free” page, and don’t expect a response with in hours. That should solve the problem.

    I am not trying to get into it with you, I am just attempting to have you see it from others point of view. I have seen you snap and people, and accuse people and that is just bad business. You have a wealth of knowledge, and it can be valuable when you respond in a professional matter.

  1156. January 23rd, 2012 at 11:52 am #James

    I had a contrator installing hardward floors, they cut a water line and I have water damage in my finished basement. State Farm doesn’t want to pay our normal income for the 3 days we had to take off in dealing with this mess, they are offering about 60%, said they normally dont pay for the time off work. Also, they want to depreciate the carpet downstairs. My question on the carpet is what if my homeowners policy has endorsement for replacement costs, can the contractors insurance company force me to depreciate it? Should I quit negotiating with the contractors insurance company and go directly to mine and then let the two insurance companies fight it out?

  1157. January 23rd, 2012 at 12:25 pm #M. James

    We had a house fire in December. It is not a total loss and the home will be repaired as well as all the contents being replaced. My wife and I are getting a divorce. Could the divorce negatively affect us in such ways as forfeitting our payout or anything like that? We intend to split it all.

  1158. January 23rd, 2012 at 1:51 pm #t. wells

    Please forgive me if this is a dupicate, but I submitted a question and when I logged back on, can’t see it anywhere. First, thank you in advance for your valuable time, and any advice you can give.

    My question in short is: Other than utility bills, how can I provide evidence that will satisfy the insurance co. that my commercial building wasn’t vacant?

    The situation is thus: We have a two story commercial building. On Christmas Eve there was apparently a break in a toilet valve that caused $39,000 (according to the estimate by the adjustor). The top floor where the valve broke was vacant, but my husband used the bottom floor for his business. The problem is, he wasn’t there 9-5 every day. 90% of his business was done in clients’ homes. He occasionally did a presentation or meeting in the building, or went there to make calls, etc. The utility bills are minimal, so they don’t help us. (Since he only needed one room, we kept the thermostat on about 60 and he just took in a space heater instead of heating up the whole building.) The insurance co. is saying that the building looks vacant from the photos that were taken. We were obviously trying to prevent as much damage as possible, so we moved his furniture, books, etc. out as soon as we arrived, and certainly before taking the pictures. What else can I use as satisfying proof he used the bottom floor?

    Again, thanks.
    T. Wells

  1159. January 23rd, 2012 at 2:44 pm #Jason

    Barbara,
    The insurance likely won’t cover the damage as you described. Incorrect work done by a a contractor is excluded. The one that needs to fix that damage is the contractor because they caused it. If they don’t work won’t fix it, then you would have to because it is your home and you have a vested interest in the home’s soundness.

  1160. January 23rd, 2012 at 3:27 pm #Judie

    I own a condo that flooded the unit below. I paid to repair the damage because the owners had tenants coming in the next month. I was expecting the insurance check to be issued to me for the damages being that I was the policy holder and the premium payer. When I talked to the insurance underwritter she told me that I would not be getting the check and that the check would be issued to the owners of the unit below that I repaired. I called the adjuster on this and he reassured me that if I sent him my receipts that I would be issued a check for my amount. This did not happen. The owners of the repaired unit now have a $4200 check and the repairs which I paid for. I am having a hard time collecting my money due me. They are ignoring me. Also the adjuster alotted them repairs in 2 rooms that had no damage at all! This was half of the alotted due. New carpet and paint for rooms that had not been touched by a drop of water!
    What do I do to recap my money ? What do you suggest over all this deceit?

    Thank you!

  1161. January 23rd, 2012 at 3:34 pm #Casi-lee

    Hi Jason, thank you for your speedy response and great information!! Just wanted to clarify that the ins companys’ investgation ( forensics co.) determined that we have landscape grade issues (they found that there was dampness) and that mold in our crawl space was caused by the grade not the water escaping from the tank and draining under the house. The forensic co. also determined that the tank pressure reief valve went and eventally plugged the pan, which overflowed. They say the mold in the house was caused by the dampness and mold below below,and that it was made worse by the hot water heater incident. Now that we have threatened to sue the ins. co, they have changed their stance to the cause of damage (excluding mold) in our home being the drain pan. Not sure why they are changing their mind now. Any idea? Also the tank is in storage and is way buried with all thats going on here, so I dont know that we will get it for them, despite losing the deductible. We wont be penalized for that will we? Thanks very much, you help so many people who are dealing with such stressful stuff. Never mind the negative people, you are doing wonderful things! 🙂

  1162. January 23rd, 2012 at 3:56 pm #admin

    Observer, Justme222 and Jason,

    Although good writing would dictate that a comment like saying “Jason is wrong 50% of the time” should include the qualifier “in my opinion”, or simply IMO, I think that any reasonably intelligent (even half illiterate) visitor here can see that Justme222 was stating HER opinion, since she has obviously not posted a rebuttal to 50% of those 120+ comments made by Jason. And I would guess that a good percentage of the advice given in this website is “opinion” anyway, without using the qualifiers “in my opinion” or “based on my experience”. I am certainly guilty of that myself.

    Regarding the Donations thing, it seems to be a growing idea. Shortly before it was begun on this website, the same thing was started at allexperts.com. In fact, it has become such a trend in ecommerce today that Paypal has made it easy for anyone to set up a Donations link to their Paypal account. Even a donation as little as $5.00 would buy your contributor a nice value meal at McDonalds, a small price to pay if the information helped the visitor, and certainly a lot less than what you would pay a lawyer or public adjuster.

    Signing up for Donations here at ICH.org is easy and open to all contributors, anyone offering advice on this website. Just go to the orange Donations link in the upper right sidebar and read more.

    For all you visitor’s information, any comments that include links are temporarily blocked by a spam blocker. They are held back for approval, then usually ok’d within 24 hours.

  1163. January 23rd, 2012 at 4:09 pm #Eric

    Great site. Lots of knowledge here, which is hard to come by these days…
    I recently had a fire at my apartment building which I don’t reside in. Its not a total loss, but one unit got it pretty bad. I’ve got a few quotes which all seem pretty high. My question is….if i get a check from the insurance company (whith mortgagee) as payee, am I obligated to use that company that gave me the high quote? Can I be my own subcontractor? I have several friends that can do it for significantly cheaper. If so, am I entitled to keep the balance of claim. Is my mortgage company obligated to keep the difference and add it to my principle, or can they reimburse me the difference as long as the work is done satisfactory? cheers!

  1164. January 23rd, 2012 at 5:41 pm #Jason

    M. James,
    The divorces will have no affect on the results of the insurance but the divorce might complicate things affecting how the claim settlement goes.

  1165. January 23rd, 2012 at 5:53 pm #Jason

    Eric,
    Your mortgage holder simply wants to make sure the work is completed in a sufficient manner. If there are additional funds, the mortgage holder will provide those to you since they have no need for them. It’s your insurance, your damage, and your money. They just hold the money to make sure the work is completed to protect their collateral supporting the loan.

  1166. January 23rd, 2012 at 6:07 pm #Jason

    James,
    Use you insurance company. Your insurance company and your contract with them provides replacement cost while the contractor, by law, only owes you AVC Pay your deductible but your insurance company will attempt to recover that back for you.

  1167. January 23rd, 2012 at 6:18 pm #Jason

    Casi-lee,
    It is hard to get into the middle of a claim and provide accurate and objective information about what is going to happen and what the insurance copmapny plans are. It seems like you have a good handle on with what is happening with your claim that I don’t think we can provide any assistance to what you have already done and are doing. Please post again if you need any type of assistance regarding your claim or any future claims. We would be happy to assist you in any way we can.

  1168. January 23rd, 2012 at 6:29 pm #Jason

    Judie,
    You should not pay for anything with you own money when you have insurance. If you had insurance and you were legally liable for the damage in the unit below, your insurance would have paid or it.

    I see your only option is to submit a letter and an invoice to your insurance company indicating you paid something you legally owed because of your liability and that you request to be reimbursed from your insurance company for things you pay your premium for that protection. If you want to provide more information, detail, and a draft letter to our address at the top right of this page in orange that starts with complete…., we will help you draft the most persuasive letter that we can or you.

  1169. January 23rd, 2012 at 6:47 pm #Jason

    t. wells,
    There are certain requirements concerning the vacancy of a building and you need to know those requirements before you try to support one situation over another. Utility bills can support it. Telephone bills can support it. Affidavits from customers can support it. Service bills from maintenance people can help, a cleaning service if you had one can supply a statement and invoices for their work. Delivery records or post office records deliverying mail to the tenants are a form of support. An affidavit from your tenant or tenants can support your contentions and so can your receipts for their rent for the period of time it was vacant. I’m sure if you used you imagination, you could come up with at least a dozen more ways to prove it was occupied. Vacancy should be fairly easy to prove.

  1170. January 24th, 2012 at 7:38 pm #Gloria wilson

    I have four claims on my homeowners insurance so my company canceled me now I can not find anyone to help me get insurance where do I go for help

  1171. January 24th, 2012 at 8:49 pm #Jason

    Gloria,
    Find an independent insurance adjuster. One that represents dozens of companies he will be able to find a company that will take you. You might have to have a large deductible like $2500 or so but then you got to stop making claims because 4 claims is rather excessive.

  1172. January 24th, 2012 at 8:55 pm #observer

    *independent insurance agent.

  1173. January 26th, 2012 at 8:19 am #KC

    Good Afternoon,

    First, I just want to say that it’s refreashing to see someone taking the time to help answer questions. I have read through the first 20 post to see if the question I am about to ask was already cover.

    I had damage to my basement and other portion of my home during most recent hurricane. The adjuster came out and due to mold I was informed to go ahead and get the work started because it was going to take him a while to get the figures back to the insurance due to the amount of work load he now has because of the hurricane. I got all but two things done and paid for all work by cash. A month later I received a check from the insurance minus depreciation of which I can recoup if I show receipts paying more than adjuster estimates. The check was made out to my husband and I and the mortgage company. I check the mortgage company website and they ask for receipts, adjuster’s report and a check made out to them to verify repairs and the check endorse. I did all but endorse the check because I believe they should be endorsing it to me. They returned the check to me with a note that I need to endorse the check and send back to them. I immediately called to ask why I need to endorse my check to them. They say it is their procedure to deposit it to my escrow. I asked why would I want to do that when I paid all this money out. The gentleman place me on hold then got back on the phone and asked me for an email address. He sent me some waiver form to sign acknowledging the repairs and for me to send everything back to them.

    I am confuse here, I don’t understand why I need to sign anything when they have all the receipts and the fact they cashed my check to verify repair of which they have not done.

    Can the mortgage company refuse to endorse my check?
    Can the mortgage company place insurance funds in escrow?
    Did I have to provide them receipts?
    Can they charge me to view repairs?
    Should I sign the waiver?

    Please advice. Thank you so much.

  1174. January 26th, 2012 at 8:59 am #justme222

    Observer,

    WELL SAID!!!!!!!

    Jason,

    JUST BE NICE!!!!!

  1175. January 26th, 2012 at 12:36 pm #Jason

    KC,
    In a way everything you did with you claim was nearly backwards. Banks are no set up to do things backwards.

    In the end, it will work out like it should but it won’t make sense for you right away.

    Yo address your questions:
    Can the mortgage company refuse to endorse my check? YES
    Can the mortgage company place insurance funds in escrow? YES
    Did I have to provide them receipts? YES
    Can they charge me to view repairs? PROBABLY
    Should I sign the waiver? i DON’T KNOW TO WHICH WAIVER YOU CITE.

  1176. January 26th, 2012 at 12:39 pm #Jason

    KC,
    In a way everything you did with your claim was nearly backwards. Banks are not set up to do things backwards.

    In the end, it will work out like it should but it won’t make sense for you right away.

    to address your questions:
    Can the mortgage company refuse to endorse your check, placed funds in escrow, require you to provide receipts and the answer is YES

    Can they charge me to view repairs? PROBABLY
    Should I sign the waiver? i DON’T KNOW TO WHICH WAIVER YOU CITE.

  1177. January 26th, 2012 at 11:24 pm #Donna

    I had a condo that I was short selling and had been vacant for a couple years. My realtor accidently overflowed the toilet and caused a water leak in the unit and also damaged the unit below. Unfortunately I did not have condo insurance. The owner in the unit below filed an insurance claim and had her unit fixed. My realtor paid her deductible due to it being his fault. It closed escrow in October. I just got a letter from the owner of the unit below demanding damages of $26,000 for repairs. Her insurance company also sent me a letter asking for $17,000. Is this legal? What should I do?

  1178. January 27th, 2012 at 6:36 am #Jason

    Donna,
    One of these two letters for money is legitimate – which one, we do’n’t know. If you are going to have property that can cause damage to other people’s damage, you need insurance or you are self insured. What should you do? Pay for the damage your unit caused.

  1179. January 27th, 2012 at 9:20 am #KC

    Jason,

    Thanks for the response. I don’t understand when you said I did things backward. I never did a claim before, but I thought when you have damage the first thing to do is to notify the insurance company- that I did. I have a very sick child who is Tracheostomy dependent due to respiratory issue at home and when the adjusted noted the mold I wasted no time to call the insurance who along with the adjuster advices me to get someone in immediately. They had some company call who assist them with providing license workers, but they stated they had no one for where I am located so I was advise to go through my phone books and made calls. At the time no one wanted to come out to do estimates, they had waiting list and was only immediately responding to individuals who wanted them to start working right away. I did and paid upon completion. I really gave no thought back to the insurance, but considering I made the claim and I am reported as having a claim I figure I should take the money.

    They sent me a Waiver of Lien for the contractors to sign and a letter of satisfaction. I don’t understand why they need those when the receipts show final payment.

    Again, thank you so much for the quick response.

  1180. January 27th, 2012 at 9:26 am #KC

    One more thing.

    I had to send the mortgage company a check for them to come to my home to view the repairs. They already cashed my check, but haven’t schedule and appointment to come out.

    The question was- should I have to pay the mortgage company for them to come out to my home. Shouldn’t they just come?

  1181. January 27th, 2012 at 12:23 pm #Jason

    KC,
    The waiver of lien if likely a document indicating the bills you have provided are complete, sufficient, and not lacking and working that was done. In a way it is to protect your interest for scrupulous contractors that will cause havoc on a family by doing what they think is right but leaving a door open for extreme complication and expense. Expense that most likely the insurance would have to pay for if they didn’t address this potential problem.

    I should think the waiver of lien is another one of those things that can come back and bite you in the rear and the insurance company too if they think they are paying a reasonable bill and if what they are paying is just a small part of the total bill .

  1182. January 27th, 2012 at 12:28 pm #Jason

    KC,
    Nothing is free line life. If thy have come send someone out to inspect that the repairs are done, that person will have to be paid. This is just how things work.

  1183. January 27th, 2012 at 1:40 pm #KC

    Jason,

    Thanks once again. You are doing a great job.

  1184. January 27th, 2012 at 5:27 pm #SN

    Okay, so I’m new to this whole thing and need some clarification. We had a recent snow/ice storm which was NOT that bad (got about 8 in over the course of a week). At the end of the week as things started to melt, water seeped into the house. After much back and forth it was discovered that this was due to a missing water/ice shield layer on the roof. All residents (this is a townhome development) dried things up the best that they could.

    Adjusters came out today and told me everything looked good with the exception of one bathroom wall which should probably be opened up. I have a couple of questions about this: neightbors have been using ServiceMaster to assess damage and it seems like they are worse off than I am (according to my adjuster). Is ServiceMaster a type of adjuster? Or are they simply assessing it prior to starting a repair?

    Also, the roofing company has agreed to repair the roofs of our entire development. This includes ripping up shingles in our “valley” areas and lining it with the shielding membrane. If they have agreed to do this at no charge to our residents, is this not taking responsibility for the fact that there was a defect to begin with? And if so, doesn’t that mean that they are in turn responsible for any internal damage the homes sustained? I’m just confused as to why people were so upset when the roofers initially denied liability but now are okay with having their insurance cover internal damage. ANY damage due to the roofing defect should be covered, if not by the roofers, than by the developer who hired the roofing co….no?

    Please offer any clarification you can on this. I know these are all ignorant questions, but I am way out of my knowledge base here. I am especially concerned about an underappreciation of damage by the adjusters that came out versus an OVERestimate that might result from someone looking for work (ServiceMaster).

    Thanks in advance,
    SN

  1185. January 27th, 2012 at 5:41 pm #Staceyk

    I wanted to know about Farmers insurance and a leaky roof claim. According to our roofer, debris from the house builder stucco, mud, and moss were growing and caused a dam- the water then ran into my house down the walls and the carpet. Our insurance said that NOTHING IS COVERED!!!!!!! PLEASE HELP

  1186. January 28th, 2012 at 10:06 am #Jason

    KC,
    Service master is a repairer.

    No, it is not an admittance of anything. It is simple a repair of their work product. Insurance doesn’t ever cover work project because if the work product isn’t wasn’t correctly done the first time it can be done correctly the second time. Or third time if required.

    Sometimes people do things out of good will or to reduce the damage they do do their name an their reputation. Not all of it is understood.

  1187. January 28th, 2012 at 10:09 am #Jason

    Stacey,
    if nothing is covered, you and they know more about it than we do so how do you want us to provide information that we know even less than they do?

  1188. January 29th, 2012 at 2:05 pm #Gaby

    California Multi-Family Condos. My ceilings fell due to negligence of roofer who didn’t cover exposed wood to rain when he was replacing the building’s roof. We have no ceilings, insulation or heat (which was ceiling heat). Also 9 other units were affected to lesser and still varying degrees.

    Roofer’s insurance isn’t paying. HOA insurance said they wouldn’t pay, but they are now taking their time giving us their assessment. My own insurance said they wouldn’t pay for the ceiling repairs, but since it’s been 3 months I’ve pleaded with them to look at the bids I have and they said they would–it’s been 10 days since I’ve heard from them.

    I have a feeling it’s going to cost more than I will receive from HOA insurance. The HOA board wants to be in control of how repairs are done, they want to pick the contractor, and they want to delegate how much money will go where and if there are leftovers they want to put it in the pot.

    QUESTIONs:
    1. Can the HOA decide how much money goes where, or do they have to divide the money up to each unit according to cost of repairs? Can they decide the contractor? (or does this all depend on the CC&R’s?)

    2. If my own insurance is willing to pay for my own repairs, do I need to disclose that to the HOA board/insurance? Am I still able to receive money from the HOA insurance, even if it’s more than I need?

    3. Both my own insurance and the HOA insurance is Allstate… Does Allstate’s info overlap? Will my agent know that an HOA claim is also filed?

    THANK YOU!!

  1189. January 29th, 2012 at 3:06 pm #Jason

    Gaby,
    The work product of any contractor is excluded from coverage. This is the roofers work product. It’s NOT covered. The remedy he had is to do his work product correctly the next time he does it. Does your unit owner’s insurance cover his work product? NO!.

    Your insurance said they would look at the bills; they will not pay for them. Don’t be confused with those words. They will not pay any of your bills

    Sure, this will need to be fixed and probably by the association because they have the most money and they have a vested interest in getting the repairs completed so they don’t have rot, fungus, and mold filled units that will be worthless in a short amount of time.

    Master HOA policies always talk to unit owner’s policies. Neither policy is supposed to pay for this but the Master HOA policy will pay so they don’t lose as much as they would if they did nothing.

    Now, to get to the important question of how much money you will personally get from this claim, it will be just a little under zero dollars. If that doesn’t make sense. Neither policy covers for this damage but one will step up aso the damage isn’t catastrophic.

    As far as left over money in the “pot”, there is not going to be any left over money in the pot. Forget there even being a pot.

    The HOA isn’t responsible for this damage but they are going to take care of it because they have the most to lose if they do nothing. Will they make sure some unit owners get more money than others? NO, They will just get the repairs done and then try to collect the money from the roofer.

    Gaby, I won’t say this gain. Your unit owner’s insurance will not pay you for any of this damage. They don’t belong there and they won’t pay you a dime. If you wanna keep making claims for this damage, you will have exactly as many denials as you have claims that you initiated.

  1190. January 30th, 2012 at 9:08 am #Linda

    I had wind damage on my roof about 3 years ago and was paid for the damage. Now I have had it again and it is much worse than the first time. Will the insurance company pay me AGAIN so soon after the first claim?

  1191. January 30th, 2012 at 10:23 am #Stevie

    If glass breaks in my living room from a covered peril, and the adjuster’s estimate only allows for cleaning the carpet, and I think it should be replaced, is the adjuster liable for any future injuries from glass?

    Just because he/she doesn’t allow for it in the estimate, does this create a liability issue for (1) ME; (2) the insurer; (3) the adjuster?

    Thanks,

    Stevie

  1192. January 31st, 2012 at 8:45 am #jenny

    My house has a water claim, my insurance company said they might not pay because my heating system is out of oil. But the reason of the pipe broken was not like because of the icing. my house has a air condition system as well as a oil heating system, even out of oil the air condition will work to heat up the house, not so warm, but still will heat enough to avoid icing. Could they refuse to pay? what shall I do?

    Thanks very much!

  1193. January 31st, 2012 at 11:27 am #Joan

    My home sustained significant damage because of an electrical surge. I have been approached by a reporter to talk about the incident. If I did, could this in anyway hurt my insurance claim?

  1194. January 31st, 2012 at 6:54 pm #Jason

    joan,
    It could. Politely decline.

  1195. January 31st, 2012 at 7:02 pm #Jason

    Linda,
    We don’t know.

  1196. January 31st, 2012 at 7:05 pm #Jason

    Steven,
    Get the carpets cleaned and stop worrying about things that will never occur.

  1197. January 31st, 2012 at 7:11 pm #Jason

    Jenny,
    We don’t know what they will cover, if thing. If things need to be fixed, fix your home as the homeowner and be concerned if it will be paid later.

  1198. February 2nd, 2012 at 6:00 pm #George

    Hello All,

    I have been searching the web to find out some answers on filing a second claim. I had my siding replaced from hail damage by filing an insurance claim. The siding company replaced our siding and within a few months after several rain storms, I started noticing that water was coming through our cieling, it was small at first but after several more rain storms I started to notice that the damage was geeting bigger and he area was coming from a small pitched roof in my living room – nowater pipes or lines so rulled that out. After I removed one of the High hats, i noticed black on the inside of the roof on both sides of the joist. It was coming from a valley (16 inchs). I called the owner of the siding company, he sends out forman…trys to calkk…another storm comes, water is no dripping (Itoke video of where the water was coming) sent pictures and the clip to owner, sends out one of his formans, reapirs it or assumes that he repaired it, more storms, more water, more cieling damage, the owner never comes out but resends another forman. Here the flashings were put upside down. it was corrected after the 5th or so visit. Water has stopped coming in (Yeah) but now I have a damage and warped cieling with balk mold. he has not returned my calls or e-mails for repairing the ceiling and removing the mold.

    Soory for the rant, but I have searching what to do and affraid if I call the insurance comapny they will flag or drop me. I have liberty insurance, can I file a claim ontop of my original claim? I do not want to pay a high deuctible I have again for something that was part of the first claim or do I have to get estimates and file a small claims court against the siding company?

    I greatly appreciate any insight or direction

    George

  1199. February 2nd, 2012 at 7:34 pm #Jason

    Geoge,
    You you have some options for youself. Neither is good. You can and hire a qualified roof repair person to repair your interior roof.

    Of you can sue the original roofer to correct the damage. This option might me the best since they have been involved with you in the past. You might not even have to sue them – just call them everyday.

    The third option is never to bring this to the attention of your insurance company because this has nothing to do with them. They may negatively affect your insurance, or they might do things we haven’t even thought of yet.

  1200. February 3rd, 2012 at 1:16 pm #John

    Insurance company sent check to us for damages sustained by a flood in Pennsylvania. It has to be co signed by mortgage company.Is there a law that they have to release these funds after a certain time period ? Also it seems that there will be some funds left over. Who gets that? Thaks in advance for any help.

  1201. February 5th, 2012 at 6:11 am #George

    Thank you Jason for your response. I will really appreciate it. My action is to keep calling/e-mailing him till he breaks. If we go to the suit road, do you recommend I get several estimats for repair, would I need anything to create a firm ground? It’s easy for them to take your money, but a pain to get them to fix something at their fault.

    George

  1202. February 5th, 2012 at 8:13 am #Jason

    George,
    I assure you – he will break. This is not worth their sanity. Our hope is that it’s soon because it’s not easy for both of you guys.

    Fix what you have to but get an estimate ready to hand them for the entire job. Fix the things that need immediate attention.

  1203. February 5th, 2012 at 9:02 am #Jason

    John,
    When you ask if there is a certain amount of time the required to release the funds, we don’t know other than the required work needs to be completed first and documentation needs to be provided for that.

    If there are left over funds, you get those so you might want to stay on top of this.

  1204. February 5th, 2012 at 2:31 pm #Mike

    We had a break in and theft. All rooms were ransacked and it will take weeks to clean and organize things thrown all over the house. Can we claim time we spend on this clean up with our insurance claim?

  1205. February 5th, 2012 at 4:13 pm #Jason

    Mike,
    Go from room to room and focus on one room at a time. Make a checklist based on who did what and how long it took that person to complete each task they did. Then turn this list into your insurance company so they can consider it for reimbursement.

    Here are some things you shouldn’t do. Don’t indicate you had 35 hours cleaning on one room unless it actually took you that long to clean that room. Take videos to document your activity so you can support your situation. Also, don’t dictate you had 12 people cleaning 1 room for 2 total hours because that would leave a very packed room and not much can getting done with such a packed room.

  1206. February 6th, 2012 at 1:27 pm #Jeff

    Hello,

    We recently had sewer water in our basement, due to a clogged “main line” drain. Access to the floor drain, which was also clogged, was restricted by a furnace add-on. I hired a sheet-metal contractor to convert part of the existing furnace into removable pieces, whereby I could then access the floor drain (which connects to the main line) and clean out the backflow debris. Can I list the sheet metal contractor on my list of expenses for the insurance claim? Also, I believe I can list the hours I worked on unclogging the drain, correct? Thanks…

  1207. February 6th, 2012 at 5:30 pm #Jason

    Jeff,
    If you did an addition for your floor drain, I don’t see how that could be a covered activity.

    If fact, I don’t know why this type of incident would be covered? Did the water not go down? Did the water come up? Why did you have this extravagant piece of sheet metal made for this drain?

    When you say constricted by a furnace add on, none of this activity seems like it’s covered and you should not get your hopes up for coverage. Would this even exceed your deductible?

  1208. February 8th, 2012 at 8:16 am #Tammy

    My brother owns a home in Brooklyn. My mother lived in that home so he took out a homeowners policy in his name and my mother’s name. My mother passed away in May and in October the house was vandalized. The insurance company made the checks payable in both my brother’s and mother’s names. Now, he cannot cash checks because my mother’s name is on them. The insurance company will not reissue checks unless we provide them with Letters Testimentary. My mother died with NOTHING, owned no property, had no money, HAD NO WILL. Is is really necessary to go through this proceedure? Also, what about my brother’s 50% of the check. Are they allowed to keep that as well if we do not provide them with the Letters Testimentary?

  1209. February 8th, 2012 at 12:21 pm #Jason

    Letters testamentary serve certain purposes. Although your mother has no stake in the funds, they could be helpful to your brother.

  1210. February 8th, 2012 at 3:49 pm #Holloway

    I lost my home in a tornado last spring. Within a couple of weeks Allstate paid the dwelling limit of $240k. The home was an old home, with old features in a historic neighborhood. Initially I had plans to rebuild the home and seek the additional coverage under the BSRL endorsement. The replacement cost of the damaged house would have easliy run $260k, if not more. I decided not to rebuild and purchased a new home across town at a cost of $309k. I supplied Allstate an appraisal of the new purchased property which had a depreciated cost of $254k and a lot valued of $55k, $309k value in total. The new house has an attached built-in garage, the old home didn’t. Allstate is subtracting $28k (replacement cost associated with the garage) from the $254k deprectiated cost of the new home to arrive at their $/ft2 price they apply to destroyed homes square footage to calculate replacement cost. If the garage is not removed from the calculation there would be a claim above the $240k limit they’ve paid. But they are saying the cost allocated to the garage must be removed because the old home didn’t have one. It’s like I’m getting penalized because the new home has a garage. What options do I have? Thanks.

  1211. February 8th, 2012 at 6:03 pm #Jason

    Holloway,
    Your old place didn’t have a garage. Your new one does and you are being penalized because the new home has a garage. If you don’t want to be penalized for having a garage, you’ll probably have to tear it down so you won’t be penalized anymore. Life is so unfair. At least there are things we can do so we aren’t penalized for things that are so wrong.

  1212. February 9th, 2012 at 5:01 am #Tammy

    Jason…
    You really did not answer my question. Is the insurance company allowed to keep the whole check if we don’t provide Letters testamentary? My brother is entitled to 50% of the check. My mother died without a will, without a penny to her name. My brother took good care of her and supported her. Are Letters testamentary mandatory?

  1213. February 9th, 2012 at 6:43 am #Jason

    Tammy,
    Please review the response because the question was answered. Your brother (at this time) is entitled to 0% of the check. If you want your brother to receive 100% of the check, yes, the Letters Testamentary are required. I even answered your question concerning if they can keep all the proceeds or just a portion.

    Please let me know what part of my response was confusing so I can improve on the way I provide future answers. I provide information on a voluntary basis on this web site and rely on the donations provided by people, like you, who receive the valuable information I post on here in both a timely and reliable fashion.

  1214. February 11th, 2012 at 8:21 am #Tasha

    I recently had a house fire and im dealing with erie insurance. And all the negative things you say insurers do to deny your claim (proof of loss forms, euo, giving 3 recorded statements, condescending adjuster) are all happening to me. The fire was ruled arson. What should i be doing? Should i be concerned about denial or having to get a lawyer/adjuster i cant afford? I lost everything and am stressed.

  1215. February 11th, 2012 at 9:21 am #Jason

    Tasha,
    Arson is the intentional burning of property, usually caused by a homeowner for a financial gain. (payment of a claim).

    Arson could technically be vandalism which would mean that someone vandalized your house by burning it. Vandalism by fire is very rare. If you had a house fire and it wasn’t ruled arson, the circumstances would be entirely different.

    Yes, if the fire is arson and was caused by you or ordered by you or an insured, then a denial is in order.

    If my property fire was found to be arson, I personally would have an attorney next to me.

  1216. February 13th, 2012 at 7:27 am #Tasha

    The fire was not caused by me or ordered by me or an insured!

  1217. February 13th, 2012 at 7:42 am #Jason

    Tasha,
    You indicated the fire was ruled arson. Where did it start and how did it start? A fire cannot be labeled as arson without that information. Who are the fire investigators referring to as the suspect of starting the fire?

  1218. February 13th, 2012 at 7:48 am #Tammy

    JASON: This was your response to me: “Letters testamentary serve certain purposes. Although your mother has no stake in the funds, they could be helpful to your brother.” How does that respose answer anything I asked? And what is this “Donation” reference you made?

  1219. February 13th, 2012 at 8:38 am #Jason

    Tammy,
    Your mother is deceased and there is no way that she can sign the check that contains here name. How can her signature be substituted for purposes of this check? It can be done with Letters Testamentary.

    I have answered your question several times right now. I can only answer the questions, I cannot cause you to understand them.

    Your alternative to asking the questions on this forum and receiving free answers is to ask these questions to an attorney. In your case, you would have asked the attorney the same question 3 times without understanding the response. For you to utilize the time of an attorney, they will be charging you for their time and knowledge of around $200/hr. The information I provide does not have the $200/hr connection but there is an option that people can donate for the knowledge, education, and experience I provide in my answers.

    In review of your situation, you have nothing to gain financially from the information you receive. Only your brother has the ability to gain financially (receive the funds of the check) It is clear you won’t pay an attorney for the answers, otherwise you would have done so already. I have to implement a policy to refrain from addressing indirect insurance questions such as yours.

  1220. February 13th, 2012 at 9:11 am #justme222

    Jason,

    BE NICE!!!

  1221. February 13th, 2012 at 9:17 am #Tasha

    I was told it started in a hallway and some accelerants were used(no more info was given).

    I was interviewed by a fire investigator and was told if they had anymore questions they would contact me. I obatained the fire report and nothing was listed as to who they are referring to as a susupect.

    My insurance, informed me that the investigation is still open.

  1222. February 13th, 2012 at 11:14 am #Jason

    Tasha,
    That tells us a lot. The accelerant confirms that it was an intentional loss. Meaning that the fire was started by someone who wanted to burn and destroy the building.

    The location of the accelerant tells us a lot too. It indicates who did not cause the fire. That would be anybody that didn’t have access to the hallway. That rules out people who are not invited in the home, live there, or who don’t have a reasonable reason to be there. So far, the list has been narrowed down to a few people.

    Of course that doesn’t rule out vandalism but there are other ways to do that.

  1223. February 13th, 2012 at 11:30 am #Jason

    Justme222,

    For someone to seek information on here and for me to provide it several times is being nice. I do that quite a bit as you can tell.

    I’ve concluded that people who aren’t directly related to a claim have no vested interested in the answer. An example of an indirect question means the information won’t affect them in any positive or negtiave way. For example, if a person asks if the roof across the street of their son’s house will be replaced with the same color shingles after windstorm fits this category.

  1224. February 13th, 2012 at 3:33 pm #Neil

    We had a fire at our house, which took out the garage on the lower level. We are currently working on a comprehensive contents claim with the insurer. One of the items destroyed in the garage was a classic Italian motor scooter, fully restored, which I had imported legally in to the US. As a collectors item, this vehicle was not run on the public roads since importation, so consequently was never registered with DMV. I held no separate vehicle insurance on this item for those reasons. In your opinion, do I have a reasonable claim for inclusion and cover under my contents portion of the policy.

  1225. February 13th, 2012 at 8:33 pm #Jason

    Neil,
    Besides not being required to be registered, it would also need to be used solely to service your residence or for the purpose of assisting the handicapped and it wasn’t used for either of those purposes BESIDES not being required to be registered.

    Based on the language of a common homeowner policy, the language referring to motor vehicles is written like this:

    We do cover “motor vehicles” not required to be registered for use on public roads or property which are:
    (a) Used solely to service an “insured’s” residence; or
    (b) Designed to assist the handicapped;

  1226. February 14th, 2012 at 4:52 pm #Sunita

    Our townhome which was rented was damaged in fire. Insurance intial estimate was for $90,000. Insurance company paid us a check less 20% for recoverable depreciation. We have completed the repair under the initial estimate by insurance as we didn’t use the restoration company insurance recommended. Our question is can we get the recoverable depreciation if we didn’t spent the toal amount?

    What all information will the insurance company need to process the recoverable depreciation amount?

  1227. February 14th, 2012 at 5:16 pm #Jason

    Sunita,
    Contact the insurance company and let them know all the repairs are completed and if they can send someone out to verify that so you can collect the recoverable depreciation.

  1228. February 16th, 2012 at 5:11 am #jackson

    We have State Farm in Texas. We recently found that tree roots have grown in sewer pipes to our toilet. I do not understand how the insurance policy is written. Is this something that would be covered? I have never filed a claim before. Thank you for your help.

  1229. February 16th, 2012 at 8:32 am #Jason

    jackson,
    It depends on how your insurance company views damage caused by tree roots. We don’t know if it would be covered and you won’t know unless you make a claim and have it investigated.

  1230. February 16th, 2012 at 1:11 pm #Anonomous

    I don’t want to be identified because of my relationship with this co. I have replacement cost contents coverage. I live in N.Y. I was covered because of sump-pump coverage. Hurricane Irene came through and caused this, but they say it wasn’t Hurricane damage.In my mind the event that caused my loss was the named peril Hurricane.We were under a Hurricane warning. I never had any flooding in my basement since buying my house 30 yrs ago. The company sent out a phone blast saying all deductibles for Hurricane claims would be waived – well, they quickly argued my claim was not Hurricane so waiving the deductible would not apply – not a good way to set a proper expectation for a customer. The out of state independent appraiser came out and told us not to worry about the prices we listed – the ins. company would figure it all out. They sent everything to a vendor who conveniently used low ball sites, including E-Bay for repricing.On one item I replaced I went to the store, & paid the cheapest they had. The claim rep. checked the store website telling me its listed for half that price. She pd me the difference for the item I replaced but said the other 2 items would not be adjusted on the ACV unless I replace them. When I argued the ACV, depreciation, (as I did not agree with a lot of it) they would not adjust anything stating I need to replace the items and then they will consider the difference – bottom line is they didnt pay me a fair overall ACV. Sounds like this coverage is a rip off. Its also extremely time consuming collecting receipts, submitting them and then waiting for them to do their processing. If not for my relationship with them, I’d file an Ins. Dept Complaint.

  1231. February 17th, 2012 at 8:37 am #Marcie

    My father in Nebraska had a pipe break in his basement that caused a flood to the entire basement area; i want to say 3 years ago. His insurance company paid for replacement of carpet and came in a put fans and sprayed some ‘mold prevention’ stuff around at time of this claim. My brothers was doing some painting in this same basement this last week and pulled a damage piece of paneling away from the way and apparently when this flood occurred this paneling and the insulation behind it got wet from the floor up about one and half feet and there is mold all over behind this paneling now traveling up the walls. So the adjuster, apparently did not see that the water did damage to this paneling and now all this paneling that got wet is not molded and has to be pulled out and all this mold has to be dealt with. Can the old claim be reopened for this damage cause by the original water damage? I think my Dad has changed insurance companies since then. Can the old insurance company be held liable for the damages cause under the original claim? Thank you for any help you can provide.

  1232. February 17th, 2012 at 10:22 am #Hemel

    Hi there – We had a theft in our home about 2 weeks ago. They took a whole bunch of jewelry, electronics (ipads, computers cameras etc), damaged property (dent in hardwood, broke sprinkler pipe in backyard, tore through a mattress), clothes, silverware etc. I have Travellers home insurance. I was told that all things like jewelry is covered just for $1000 and electronics for just $1000 etc. Do you know if these are hard limits or is there some workaround these? I am really tensed as we have lost so much and even with having home insurance we will probably get back nothing.

    Appreciate your help and advice.

    Thanks,

  1233. February 17th, 2012 at 6:13 pm #Kayla

    Hello,

    Just last weekend my kitchen ceiling fell and ruined basically everything, I had a structural engineer take a look at it and he said something about the rods being too short or too far apart- which is why the ceiling fell. Insurance was not able to come out until today- a week later and they are trying to tell me that they will not cover it because of faulty construction. I am at a total loss because I have no idea what I can do to fix this mess in my house, the house was built in 1972 and was up to code when it was built but i have learned the codes have changed and i was wondering if there was anything i can do to make my claim on why insurance should have to pay for it. it happened suddenly and to my knowledge the ceiling and all structural codes were up to date && when it was inspected everything was fine. I am very young and very scared, ANY information you could give me would be a blessing!!!

    Thank you for your time

  1234. February 18th, 2012 at 6:02 am #Tamela

    Hi, how are you? My question involves our house caught fire on December 27, 2011 and we have yet to file a claim under the advice of our attorney. The fire is under investigation, but we have heard or no nothing going on. We pretty much lost everything we own and are falling behind on bills trying to purchase clothes and things we need and our kids need. I don’t know what to do at this point, we haven’t even heard a word from our attorney in weeks. We were asleep when the fire started in my daughter’s room and really aren’t sure what happened or why it started we have heard nothing from no-one. We don’t know what to do or where to go from here and I am afraid our attorney isn’t worth having. Please give me some advice on what we should do. Thanks so much for your time!

  1235. February 22nd, 2012 at 8:06 am #Tasha

    How long should it take for an insurance company to schedule an EUO?

    Is there a time limit?

  1236. February 22nd, 2012 at 4:13 pm #spring

    Hello,

    I have a toilet supply line sudden leak and there are lots of damages. I had my contractor replaced the line. The insurance guy came and asked where is the original leaking line, but my contractor took it and I am not sure if he can find or not. Is this absolutely needed? Will my claim be denied if he can’t find it? We had a picture of it when leaking.

  1237. February 24th, 2012 at 2:25 pm #Linda

    Question. My roof has hail damage from a tornado that went through here last year. I didn’t know this until just recently when a neighbor told me. I have only a few weeks to put in a claim. Unfortunately, I was late on my insurance payment (not the first time admittedly, things have been rough here), and the company dropped me. Can I still file a claim since it happened while under their insurance? Funny, they never took into consideration that I NEVER filed a claim in all the years I’ve been paying them.

  1238. February 27th, 2012 at 6:29 pm #HH

    We recently notice a leak from under our shower, we called a plumber and he found a crack in the shower base, he is saying this has been cause by the shower frame/support failing under the shower.
    He is saying we should be able to claim it under our home owner insurance since its builders poor workman ship that has cause the failure. I am just trying to find out if this is correct before filing a claim.

  1239. March 1st, 2012 at 8:47 am #Jean Paul Bouvret

    Name four (4) of the insured’s duties under the HO 3 policy.

  1240. March 1st, 2012 at 5:53 pm #Mike

    I had water damage that included replacing part of the floor. The contractor that did the evaluation for the insurance company, explained they will use 200 sq feet of laminated wood to replace 28 sq feet, because they will need to cut the floor in pieces and interleave the new wood in. It will take at least ten hours of work, etc. In short, we went with them, because it seems reasonable. The insurance paid them, and we should pay the deductible to the contractor when they finish.

    However, the contractor did not do what he described. He just replaced 35 sq feet of floor (using two boxes of 25 sq feet of laminated wood), and left me another two boxes (50 sq feet), for a total of 100 sq feet (of the 200 sq feet they charged the insurance company). They now want my deductible. Should I deduct the unaccounted for 100 sq feet of wood of my deductible?

    I really unhappy, because they charged for 200 sq feet, used 50 sq feet; estimated ten hours of work and only used two hours. Now they want my full deductible. I believe that it is hard to argue about the working time, but at least the material they did not use (or buy) should be deducted from the deductible. Is this an small claims court type of issue?

  1241. March 2nd, 2012 at 10:53 am #Arlene

    Hi Admin and/or Jason of Insurance Claim Help

    My parents recently experienced water damage due to a burst pipe in kitchen wall (behind the sink). We submitted the claim to Tower Hill Insurance. I emailed you the denial letter, along with other documents submitted to carrier. Is there anything further that can be done? Can my parents fight the denial?

    Arlene Timothee

  1242. March 2nd, 2012 at 1:57 pm #Ro from Florida

    Hi
    Last april/may a pipe in an upstairs bathroom broke and flood my house as my sister and I were sleeping. That night/morning, it happenned at 3am, we did our best brooding all the water out and opening all the windows and airing out the house and seeing it happenned on the week end and a holiday we couldn’t get someone out to dry out the house. See the house is my dads and we have never had to file a claim we called the insurance company United Property & Casualty Insurance co. and it took them two weeks for someone to come out and assess the damages. Now we have laminate flooring in all 4 bethroom and tile everywhere else. My sister room, kitchen, dining, living room and garage got the most damage with the water seeping through the ceiling and into the walls down to the laminate floors. After the adjuster came out it took another 2 weeks or so to say they were not going to pay for my room because only the woods by the door appear to be damaged I sent pictures of the garage ceiling which is under my room showing them that mold was already forming. So another two weeks after that total of six weeks we got a check for $14221 which was great because the contractor we had told us it was going to $15000 to do the work. But as work started in August we found extra damages in the kitchen, garage, dining and my sisters walls and to make matters worst we found a second leak in the wall behind our dishwasher and when the contractor tried to take off the cabinet the whole thing came apart. We then contacted a public adjuster with adobe from others and he came an surveyed the damages and said instead of a second claim just file a supplemental claim for the extra damages. Since I’m the youngest in the family my older brothers took over and wanted to be in charge of the claim. The had to get my dad to sign and motorized and an send it to the adjuster. Fast forward to febuary of this year after 2 family members being hospitalized back to back for a total of almost 2 months the first adjuster showed up at my house to re inspect the house. Come to find out my brother did want to pay the public adjuster and went ahead and file a new claim. No just this week they sent us a check for 1100$ for the extra damages. After I contacted the adjuster he said there was nothing he could do that if we file a supplemental claim now that we’ll be flagged for fraud to just take the money and be done. Now it’s been 5 months of living the house with no kitchen so of course no sink, counter or floors. And the cheapest quote we got was $12000 for the kitchen and to replace all the flooring. Now what should my sister and I do should we file the supplemental with another adjuster? Or cut our loses until we financially are able to fix the rest? Thanks in advance.

  1243. March 2nd, 2012 at 7:54 pm #Jodi

    Hi,
    We just had a fire in 1/2 of our one floor duplex. We live in the other 1/2. The insurance company said it is not a total loss. It will be stripped to studs. Our end has smoke damage and smell, as does the attic. We own our place, so no mortgage. The contractor we used came up with a figure for repair back to the way it was. Our insurance company came real close to that as well. We are not sure we want to replace it as it was but would like to put the money into either a modular or just make the burned end a smaller rental. Can we get the full 100% of replacement value they came up with as long as we use it for this property–fixing either or both ends of the duplex? The did say they would keep the depreciation percent if we just take the money–but can we use the full 100% on what ever repairs, replacement as long as it is on the same property? We live in WA state and have Country Financial Insurance. for an example–they say it will cost $90,000 to repair but will give us $70,000 to do what ever we want–but can we get the full $90,000 if we do partial repair (make it smaller) to the burned end, if we do some repairs here at our end, or if we replace the whole thing with a modular that would cost more than that anyway? Hope this makes sense–we want to get the full replacement value but want to change the duplex plan. I think I’m so confused, I’m asking the same question over and over! Thanks for your help!

  1244. March 4th, 2012 at 2:43 am #admin

    I have no idea what happened to Jason. I sent him email long ago, but no response. This website would be much better if some of you would step up to the plate and start to answer questions. I know you are out there and listening because there are hundreds of you who subscribe to RSS Feeds for this website.

    For those who want automatic notices of new comments on this website, just click on the “comments (rss)” link at the bottom right corner of the page.

  1245. March 5th, 2012 at 3:51 am #Jim Rocchio

    I have a situation on a cesspool that back up in my home. It damage most everything in the basement. It was a total loss to the carpet, furniture and about 40 years worth of stuff. We maintain the cesspool every year because it is an older home. We called Liberty Mutual or insurance company. The adjuster said the walls have mold on them and this is a condition that has been going on for months and totally refused our claim for damages. I told him this was a new condition. I handed him receipts from a plumber I had there the cesspool company that worked on it. I have since replaced the laundry room drywell, put in a new overflow cesspool, hired a dumpster, through out everything in the basement. Liberty mutual is trying to say we are neglectful. I am sorry even if there was mold stating on the walls in places, that does not mean that this cesspool water was sitting in the basement for months. There claim for rejection is ridicules. I will continue to fight them on this. Do you have any advice?

  1246. March 6th, 2012 at 12:39 pm #Carlos

    Quick question

    Our house was burglarized and the insurance company was only going to give us $1500 dollars for an $8000.00 guitar. We have a replacement clause in our home owners insurance policy.

    We went and ordered a new replacement guitar from the music store and paid for the full price of the guitar.
    The insurance company sent us a check for the full cost of the replacement for the guitar.

    Question, we have not received the guitar due to it being on back order from the factory. Can we simply cancel the order from the music store and take our refund back and keep the money?

    If we were to wait and receive the guitar and return the guitar with-in the 30 day return refund policy at the store would we have to return any money back to the insurance company?

    We really just felt cheated by what the insurance company were doing . They gave us a 80% depreciation which forced us to replace the guitar, but the old guitar had huge sentimental value and with the replacement guitar we would probably just sell it on ebay etc.

    Just curious if we can just return the guitar back to music store and keep the money?

    Thanks

  1247. March 11th, 2012 at 3:53 am #BT

    My father has a a small family non commercial farm.A stand alone barn that housed small farm equipment burned due to work a large utility company was doing near by.My fathers homeowners insurance company is low-balling the claim stating diminished value of the equipment housed within, as well as the age of the barn itself.
    Question #1: Is there a standard “formula” for value of said equipment?
    Question #2: If the barn is up to local code, can the age of the barn that burned hold any relevance in the claim?
    Question#3: Is there a legal resource available to assist against a large utilities company with ties to most lawyers in this small rural community?

    Thank you in advance for your assistance in this important matter.

  1248. March 16th, 2012 at 2:49 pm #Alex

    My wife and I recently separated. A couple months ago some contractors showed up in the area and told her the house was damaged from hail. Someone then filed a claim with my homeowner’s insurance and they sent a check. She also signed my name to a contract with the contractors. Is she allowed to file claims against insurance that is in my name? If not, what should I do about this?

  1249. March 21st, 2012 at 9:21 am #Mark Dent

    My Jenn Air $1,000 two year old dishwasher that is out of warranty failed. The water valve had a leak in it. The 3/4″ oak floor in my kitchen was installed after my cabneits and the kitchen is over top a very small craw space. After a couple of years of use the floor in my kitchen started to warp, when I called a floor man to take care of it, we discovered the probelm was the leaking dishwasher. Safeco denied the claim stating I do not have coverage for a slow leak stating the damage to the floor and cabniets would not have happened if I knew there was a problem earlier. The only was to detect the issue earlier would have been to deinstall the dishwasher and inspect the floor. On Safeco’s advise I contacted Whirlpool and submitted a claim. I jumped though many hoops and sent them the part. They said they did not manufacture the part that failed and thus they were not liable. They sent the part and paperwork to ESIS Insurance Services that represents Invesys Controls, the part manufacture. They are testing the part to see if it they are liable. My questions are:

    1) Is safco really off the hook? The language in the policy sure reads like they are, but is it really reasonable to have to remove your dishwasher on a daily basis to insure it is not leaking?

    2) Whirlpool and Invesys Controls. I am somewhat surprised that they would even consider paying the $11,000 estimate on the kitchen repairs. What responsibility do they have?

    Mark

    410-808-4109

  1250. April 6th, 2012 at 1:00 pm #Becky

    Hi

    I just found your site and have some questions, I own several condos as rental investments and I have my insurance with Kemper. One condo has water damage from the unit above, this owner had a leaky shower value, they replaced it and the water instrusion problem stopped. Now I have a bathroom and part of the bedroom ripped apart. Her insurance co, USAA denied my claim, saying CCRs say any damage in my unit is my responsibility to repair damages. I went to my insurance co and they just informed me that I only have $1000.00 coverage for the drywall replacement. I have a policy that shows I have $30,000 for personal property, which my agent told me would cover any inside damages, (I even spoke directly with agent when renewing 3 mos ago about wanting to be sure drywall, flooring, etc were going to be covered. He said it turns out Kemper makes them put on something called “Unit Owners Coverage” and he did not know this and this would cover drywall, flooring. Now the agency and the underwritter are going back and forth or who if anyone is going to cover my loss. I am considering suing the owner above me in small claims court for the loss, but you never know how a judge will rule. Any thoughts?
    As this has shined a light on how poorly my policies (6 total, not including my own home and 2nd home I have) had been written I have now added on the “Unit Owners Coverage”. Now I am wondering, if there is a fire, do I need to make sure I have enough to cover the framing, electrical, plumbing, possibly the roof? My agent says no, that would be the responsibility of the HOA, but admits condo ins has a lot of “gray areas”. I am very nervous with my ins co now and I just want to be sure I have the correct coverage in place to cover any loss. Any help is greatly appreciated.

  1251. April 6th, 2012 at 1:12 pm #Jason

    Becky,
    Because the upstairs neighbor did nothing negligent, it is clear a judge or jury would rule in your neighbors favor. It would be a waste of time and resources to sue your neighbor.

  1252. April 6th, 2012 at 3:14 pm #Kari

    Becky- it would be wise to review all of your condo rentals- coverage A is for drywall, carpet etc. if there is a fire sure your association will basically rebuild to framing. Dwelling coverage A covers that. Review the master condo policy and association papers to see what is actually required. If anything your agent has E & O coverage so if you feel his didn’t properly write your policy based on his admission, and left you wide open for a loss he could be responsible.

  1253. April 7th, 2012 at 6:40 pm #Ro from Florida

    I posted a question back on march 2nd can you please let me know my options. Thanks

  1254. April 7th, 2012 at 6:53 pm #Jason

    Ro,
    We have no idea what your options are based on the circumstances you posted.

  1255. April 9th, 2012 at 12:19 pm #Gail

    Six weeks ago someone drove their car accross my front yard, tearing out 80 feet of hedge and seriously damaging a 60 foot spruce tree. The damage is extensive enough that all 40 hedges need to be replaced and the tree needs to be taken down. I have submitted the 2 estimates as asked for, both in agreement of what needs to be done and within a few hundred dollars of each other. The insurance company has done nothing but drag their feet. As of today they have told me they are waiting for “their” tree expert to tell them what needs to be done. If they are able to drag in anyone they want, then why did I have to get any estimates at all? I just want this finished so I can clean up all this mess. Help!

  1256. April 9th, 2012 at 1:49 pm #Jason

    Gail,
    If you are not content with the way the claim is going, submit it to your insurance company.

    What the insurance company is doing sounds entirely reasonable. You indicated that the car tore out 80 feet of hedge. If the hedge is pruned and roughly 4 feet tall and otherwise healthy, the car – even traveling at a good rate of speed – will lose all of it’s momentum before it travels through even half of that hedge. Also, a hedge is not a single and continuous plant. It is many separate plants that appear to be continuous. The insurance company must determine which plants are damaged and what their obligation happens to be.

    Also, a car that has lost it’s momentum from the 80 feet of hedges is going to do little damage to a spruce tree so they have to determine what they owe for that as well – if it’s even possible to hit the tree after being slowed or stopped by the hedges.

  1257. April 14th, 2012 at 11:31 am #Wayne

    My brother-in-law, a home builder now performing roof repairs, replaced my roof last year. The invoice that was mailed to the insurance claim, stated the total charges, a “discount” for sign advertising, the revised job (total charges less discount), and the payments that were made by me (which totaled the revised charges).

    My brother-in-law mentioned that the insurance would pay the total charges, I was betting that they would pay the revised, less my deductible of $500, since the advertisement was a rebate.

    After reviewing my bank account, it seems the insurance actually paid the revised total. Since the revised total is the amount I actually paid for the repairs, shouldn’t the insurance company have subtracted my deductible?

    If so, how should I return the deductible, it has been many months since the check was received.

  1258. April 15th, 2012 at 10:44 am #Jason

    Wayne,
    You seem to conclude the insurance company did not apply your deductible. It is not appropriate to assume that based on the limited information you posted. You don’t know if there was a supplement and unknown cost incurred and billed by your brother-in-law, you don’t know if a deductible even applied to your particular loss, or you don’t know how the insurance company calculated these figures.

    You should not consider returning your deductible because that would be like paying your deductible twice. Your insurance company considers your claim “settled” and by you submitting money to your insurance company other than for payment of your premium would cause chaos and confusion.

  1259. April 16th, 2012 at 4:40 am #Chad

    My roof was damaged by a large tree branch during a wind storm. I called my homeowners and they came out and looked at it, however, they told me it was a patch job and only 1200 worth the damage and I have a 1000 deductible,however, if they patch the roof the shingles won’t match the 15 year old roof now. I argued with the insurance company telling them it needs to match and be to code, however, I have 4 shingles that don’t match at all from a previous repair and my insurance agent is telling me this is why they can’t replace the whole roof. If they are going to patch it too, won’t they be breaking the code as well?

  1260. April 16th, 2012 at 7:11 am #Jason

    Chad,
    Insurance doesn’t provide for matching and for your current roof which is already mismatched, it is the perfect fix because it had been done that way previously.

    What is this code that you refer to? Regardless what it is, it’s certain that the repair would not be in violation of it.

    One practical way to look at this is if you have no insurance what-so-ever. Would you promote that the roof is repaired or completely replace, given the fact that you have to foot the bill (in light of an already existing repair)? Since a repair is the reasonable choice, the insurance company is also making the reasonable choice.

  1261. April 18th, 2012 at 8:17 am #priscille

    We’ve lost our home in a fire. We have full replacement insurance which the insurance company is willing to give us to rebuild our home.
    If we choose not to rebuild and want a cash settlement, can we receive a percentage of this replacement cost that they have offered, or is it a percentage of the assessed value on our insurance policy (which is less)?

  1262. May 1st, 2012 at 10:16 am #Amanda

    Hello,

    My mother in laws home burned 2 months ago today. She has yet to be contacted by the insurance company. When she visits the main office, they try to contact the underwiters and the responses they get are “We are working on it” and/or “My appraiser is coming to look a the property.” What can we do to get a decent answer out of them? She is on a fixed income, she is moving from our home, to my sister in laws home, to her sisters and back. None of the family really has room for her. She was told to rent a hotel room…but on a fixed income she can’t. When the fire first happened, we were told that the policy was too young and an arson investigator would be contacting us. The investigator did come and the fire was reported as bad wiring. What can we do? The insurance company will not return any phone calls

  1263. May 1st, 2012 at 11:40 am #Jason

    Amanda,
    What we have is your report of what is going on with your mother-in-laws claim. It is difficult for her to provide us with the important details of her claim. When it is relayed through you it is even less reliable. You have provided us with nothing we can use to provide any information to you. In fact, you state the insurance company has not yet contacted her and then later you say the insurance company contacted her about having a fire investigator involved. Also, the insurance company had to contact her to let her know the fire was related to wiring. If we have unreliable details, we cannot provide accurate information

    From what you posted, we would think your mother-in-law does not have insurance but that is based on your second-hand reporting of her situation. If you want suggestions, we need to know the details more accurately.

  1264. May 2nd, 2012 at 8:39 pm #John

    Jason,

    My Allstate contents claim adjuster wants original receipts for my purchases. I purchased some items on Amazon and they don’t really provide receipts except for copies you print on your own printer. Is providing internet receipts from Amazon a problem you heard of? Should I be concern about submitting original receipts to a P.O. Box address for my Allstate contents claim? I’m trying to get reimbursed for recoverable depreciation. What if these original receipts get lost in the mail? Should I demand a physical address to send these original receipts FED EX or UPS? Do you know if Allstate is known to be difficult dealing with recoverable depreciation? I’m a little worried that they will find some way to avoid paying the claim.

  1265. May 2nd, 2012 at 11:45 pm #Rick

    I am currently losing my home, and it is up for a as is short sale or possibley foreclosure. I just recieved a check from my insurance for hail damage. The check is in my name, the amount recieved is not enough to replace the roof, can I repair it for less and keep the differance or is that insurance fraud. I will be moving out in less than a month.

  1266. May 3rd, 2012 at 6:19 am #Jason

    John,
    The amazon receipt you print on your printer is the original receipt. You should have no concern about sending anything to a post office box. If your receipts get lost in the mail, then that is something you will have to address if it ever happens. The odds of that happening are so minimal that it should not enter your mind.

    Don’t demand anything from your insurance company. They handle claims all the time and the post office box works for everybody else, so you might not want to alter the way they receive their information for claims.

    Claiming your recoverable depreciation is a matter of replacing the items, submitting the receipts, and the insurance company paying an additional amount.

  1267. May 3rd, 2012 at 6:22 am #Jason

    Rick,
    What you described is not insurance fraud. The only we find odd is if you are losing this house, why would you do any repairs in the first place?

  1268. May 3rd, 2012 at 7:39 am #Rick

    I would atlest like to repair the missing and or loose tiles to keep the roof looking good in a attempt not to scare away a potental buyer.

  1269. May 3rd, 2012 at 2:01 pm #Ellarel4

    Help,

    We have just filed a claim in CA. We noticed some shower tiles falling off at the base of our shower. Figuring it was a case of bad caulking we decided to try and fix the tiles but upon removing them we noticed no green board and rotted wood. I took down the shower enclosure and the tiles on one side and noticed that the plywood and all the beams are rotted and covered with black stuff. The black stuff (I think it’s black mold) starts at about 5 feet up the wall. We called AAA and they sent out a roof inspector. The roof guy said that it was caused by the roof leaking and not the shower tiles at the base of the shower coming loose. AAA is denying the roof but said it will put back the shower. I thought that if we had black mold they would have to test it and send out the appropriate inspectors for the job. If the roof is leaking what good is it to have the shower replaced? How do we get this taken care of?

  1270. May 3rd, 2012 at 2:54 pm #Jason

    Ellarel,
    No, the insurance company doesn’t care what the specific name of the black mold is. If you want to bring someone to test the mold, you can do that but the insurance company doesn’t need to know that kind of detail. They want to find out if it’s covered or not.

    When you, as the homeowner, repair the leaking roof, you won’t have it leaking anymore and you will likely need your shower replaced so you can use it. In order to take care of it, you will need to find a qualified contractor.

  1271. May 3rd, 2012 at 5:07 pm #Ellarel4

    Jason:
    The Insurance co. AAA is denying the claim. They do not want to fix the roof only the bathroom wall where the tiles were torn out. The inspector told me that the problem is in fact due to the roof. So if the roof is not fixed and AAA fixes the Bathroom wall the roof will still leak and the wall will continue to rot.

  1272. May 3rd, 2012 at 7:16 pm #Jason

    Ellare,
    No, the roof will not leak and the bathroom wall will not rot. You know why? Because this is your home and you as the homeowner will fix the problem. That is the responsibility of a homeowner. If you don’t fix the problems, then you will continue to have them. Homeowners, however, will fix any known issues so they don’t get bigger. If you don’t want to be a homeowner, sell your home and rent. It’s pretty simple.

  1273. May 3rd, 2012 at 10:15 pm #Ellarel4

    Wow Jason. Thanks for the responsibility lesson. If I needed help in that realm, I could have called my mom. Please leave the prickness for your children.

    So I was misinformed. AAA will ONLY cover the ROOF tiles. BUT – the quoted repair cost from AAA’s inspector is less than my deductible. The Inspector stated the damaged roof tiles were caused by WIND. This is COVERED under my insurance – which is WHY I PAY FOR IT. I’m glad I didn’t pay you for advice as you’re apparently fit for providing ridicule and none more.

    Needless to say – the quoted damage is less than my deductible because AAA is ignoring the damaged framework of the house, the insufficient risers on the roof tile edge, and rotted sublayer. They are acknowledging the broken tiles and ONLY the broken tiles.

    If anyone has better advice than Jason – please share. Can I get my own contractor to confirm that the damage was caused by wind and the improperly installed tiles? What should I do?

  1274. May 4th, 2012 at 3:01 am #Jason

    Ellarel,
    No, you misinformed us about not being clear about the tiles. People need to take responsibility for their mistakes.

    We don’t ridicule – we provide straight forward and sensible information. You can interpret reasonable and sound information any way you like.

    You can get your own contractor in there and he can confirm the damage was wind, or if you paid him enough, you could get him to say the damage was from magical beans that didn’t work correctly. However, that is not going to do you any good with the insurance company.

    Instead of looking for ways to have someone pay for your house damage, you might want to find someone to repair it so you can get it fixed and move on with life.

  1275. May 4th, 2012 at 8:01 am #Ellarel

    Jason,

    With all undue respect, you provided NO “straight forward and sensible information.” I’ll use SFSI from now on.

    How is the following statement SFSI? “No, the roof will not leak and the bathroom wall will not rot. You know why? Because this is your home and you as the homeowner will fix the problem. That is the responsibility of a homeowner.”

    Let me tell you something Obiwan, I have concrete roof titles. Do you know how to fix those? Did you know that most homeowners insurance policies cover damage caused by nature, such as wind? Mine does.

    Who crapped in your cheerios? I asked for help with dealing with the insurance company and you assume and try to make me seem like an irresponsible homeowner. Why don’t I make the assumption that you’re 45 years old, in nothing but little boy underwear, and using the computer in your mom’s basement to try and make yourself seem more intelligent than other people who are asking for help.

    You make me sorry I ever used this forum. According to you, I should have just went to a home improvement website and asked for help in repairing concrete roof tiles that were broken by high winds even though my insurance is supposed to cover that. Then I can also ask how to repair the water-damaged sublayer and framework that was a result of the wind-damaged tiles.

    Wow, what a great month! I get my house damaged by nature, I get jerked around by the insurance company, and I get an internet wannabe pundit to write rude things to me. Anyone else want to throw a pile of crap at me now? Thanks insuranceclaimhelp.org!!!

  1276. May 4th, 2012 at 8:08 am #Ellarel4

    You know what Jason – don’t bother providing anymore SFSI because all you provide sounds like BS. Please just take your aggression and need to belittle people elsewhere. That is not why I came to this site. That is not why I used this forum.

    I’m going to call my mom now and ask her what chores I need to do today since I’m not responsible and can’t take care of myself.

    In all dishonesty, I wish you a wonderful long life in your mother’s basement.

  1277. May 4th, 2012 at 7:34 pm #Jason

    Ellarel,
    It doesn’t matter what roof covering you have. The insurance company won’t become involved in your loss because it does not exceed your deductible. The water damage is not wind damage. It is water damage. And that water damage doesn’t seem to be covered by your policy.

    If you want someone to hold your hand and make everything better, that’s not going to happen. You have some damage that nobody is going to repair without charging you. Also, you won’t have anybody else pay for it so it’s something you have to pay for. This is as straight forward as it gets.

    You are looking for some advice on how to get your insurance company to cover something that isn’t covered by your policy because it doesn’t exceed your deductible. Rather than waste your time and effort doing that, we provide you with sensible information so you can get this fixed at your expense and move on with life.

    Reality is that you didn’t get jerked around by your insurance company. You submitted a claim and they clarified what is covered and what is not and the deductible you chose excused the insurance from helping out in that repair. This is what you seem to be upset about.

    This is some carefully crafted advice specially tailored for someone who seems to think the world owes them more than it does. Remember, renting is still on option for you if owning a home is too much responsibility.

  1278. May 5th, 2012 at 10:34 am #Ellarel4

    The fact of the matter is; my insurance policy covers damage to the roof from wind. The insurance provider’s inspector admitted the water damage was a result of the broken tiles. The adjuster said that AAA would cover the damage if MORE tiles were broken. Covering the damage would exceed my deductible by a lot. that is why I’d like to get an estimate from a private contractor – which was a recommendation from a considerate and helpful source (NOT JASON).

    I’m sorry, was there a clause in my policy that stated how many tiles had to break before AAA would cover the water damage? I sure haven’t been able to find that. So the wind didn’t break enough tiles for AAA to cover the damage, yet the damage is apparent (according to AAA inspector’s report) across 800 square feet. This is NOT wear and tear. This is damage caused by an event of nature; damage covered in my policy. Conveniently, the insurance provider’s inspector quoted a price just below our deductible. Also, conveniently, not enough tiles broke to justify AAA to fix the damage caused by the event of nature. I was told, “if MORE tiles had broken,” AAA would cover the water damage. Wow, that’s pretty specific, thanks Mr. Adjuster.

    Question for Jason; do work for AAA? Because it sure seems like your duty on this forum is to stick up for the insurance companies and not the people asking for help.

    I bought a home because paying a mortgage costs about the same as renting a house. Why contribute to someone else’s equity when I can invest in my own? Can I afford a new roof? No. Can I afford my deductible? Yes. Do I pay for insurance in case of emergencies? Yes. Does my insurance cover acts of nature such as high wind damage? Yes. Is Jason a complete and inconsiderate, unhelpful prick?

    Undoubtedly yes.

  1279. May 5th, 2012 at 11:56 am #Tasha H

    We had a fire November 5,2011 this is our second house fire in this home the first one was electrical the second one started in the laundry room we went through the investigation the fire chief cause of ignition was under investigation so we did the EUO in April where they questioned me and my husband about where we were and all types of thing true enough we were behind on our payment and were about to go through foreclosure but we now are in a modification and making trial payments to reduce payments and lower the debt but we received a letter today from Metropolitan stating they are denying our claim because they say their investigators found it to be incendiary in nature the result of someone intentionally lighting ignitable fluids. Then saying other evidence gathered by Metropolitan during the course of its investigation shows that me and my husband both had motive and opportunity to deliberately set the fire or to have the fire set by someone for the purpose of collecting monetary benefits from Metropolitan but this is not true .The fire that started in the laundry room and come to find out my husband did store paint thinner in the laundry room on a utility cart that our laundry detergent and other item were placed there too and when the fire chief came she showed us where the container was empty and had no top on it but by husband said he put a plastic top on it because the person that was remodoling our home did not have a top on it but I had no knowledge of the paint thinner being in there neither of us was as home when this happened but they are trying to say that me or my husband set the fire by lighting and ignitable fluid so Im trying to find out what we need to do to dispute this denial of the claim because I know this is not true

  1280. May 5th, 2012 at 11:57 am #Jason

    Ellarel,
    We will make this as simple as we can.

    Wind damaged some tiles. The insurance provides wind coverage and will pay for wind losses that exceed your deductible. The wind damage to the tiles is below your deductible.

    A separate and distinct event is now happening inside the walls of your home and is caused by water (not to be confused with wind). Wind is not causing any of the damage to your home – water is. The part about the water is that it’s an on-going condition that is not attributable to one event. The policy doesn’t provide coverage for an on-going concern like a water leak into your home. And because the wind issue is separate and distinct from the water damage, the water damage won’t be paid as a wind damage claim.

    You indicate there is damage to 800 s.f. of roofing yet you indicate it’s not wear and tear. It is difficult to provide answers when people withhold important details. Did your adjuster tell you the wind damage is minimal and the bulk of your concrete roof tile cracks are due to wear and tear?

  1281. May 5th, 2012 at 12:24 pm #Jason

    Tasha,
    A fire claim that is being denied due to arson is a very difficult, if not impossible, obstacle to overcome.

    There are a number of things the insurance company relies on before it decides a denial is in order. It’s odd you are behind on your mortgage payments to the point of being in foreclosure but you have the financial means to pay for remodeling labor and materials.

    Paint thinner on a laundry cart does’t make sense being stored with soaps. Especially if you have a garage.

    It is difficult to start, and sustain, a fire in a house. For 2 fires to be in the same house in a short time span is very improbable unless started intentionally.

  1282. May 5th, 2012 at 1:10 pm #Tasha H

    the paint thinner was stored there because we do not have a garage they are saying the the container was there with the lid off but the original lid was either lost or I don’t know what happened to it but my husband said he found a plastic lid and just put in on the cart we have all kinds of things on the cart because that is where he chose to put them they also said they were going to notify the lender to present their claim under the policy also the second fire they said it was electrical but they only rewired the room where the fire started I know for a fact neither of us started this fire or had no one else to set more than likely the top may have melted off the paint thinner when it go hot in the laundry room where the fire started I’m not sure but do you think I have a case or and attorney will look at the situation I have or what chances do I have because they are paying temporary housing for us right now and they paid it up until June 19 I don’t know what we need to do right now I am so confused I need someones help. They did not say it was exactly arson but the letter stated I. Losses we do not cover (Intentional Loss)

  1283. May 5th, 2012 at 1:32 pm #Jason

    Tasha,
    Intentional loss is arson. As long as you are willing to pay the attorney, they will take your case. It’s no skin off the attorney’s back just as long as you pay him.

    Paint thinner doesn’t just self-ignite. How did the paint thinner become ignited? What remodeling project were you having the remodeling person do? How long ago was he doing the remodeling? Is it your paint thinner or the remodeling person’s?

  1284. May 5th, 2012 at 1:40 pm #Tasha H

    well the paint thinner can was on the utility cart the remodeling project had been finished and I had put a load of clothes in the washer and the dryer was going before we left there had already been some issues with the electricity and I informed the adjuster when we had the last fire about the power going out and the breaker having to be reset when more than three or four things are going on at a time but it never happened when I would run the washer and dryer both at the same time so really I dont know what to do The only thing I know is that the fire was not intentional I’m not saying paint thinner Self-ignites I dont know how the fire started but who would be dumb enough to set a fire and leave evidence there come on now thats crazy but I just need to know what I should do

  1285. May 5th, 2012 at 1:42 pm #Tasha H

    it was not my paint thinner the guy that remolded the house must have left it over there after he was done cleaning up but my husband said he just put it in the laundry room to get it out of the room that was remolded

  1286. May 5th, 2012 at 1:50 pm #Tasha H

    and for your information you find it odd for us being behind on our house payment but had money for remodeling that is really not for you to say because for your information before we got the remodeling done we were not behind on our payments you really need to learn how to talk to people because for you to answer in the way you did you don’t sound professional and for two fires to be in a house in such a short period of time what is improbable about that. Me or my husband had no intentions of setting a fire to our home if it was in the process of foreclosure then so be it. We would have to deal with it but setting a house a fire would not do anything but cause more problems Thank you

  1287. May 5th, 2012 at 1:54 pm #Kari

    Tasha, why would you remodel a home that was in foreclosure? What did the fire report from your city determine to be the cause of the fire?

  1288. May 5th, 2012 at 2:09 pm #Kari

    Tasha, you are getting upset with the wrong people, Jason is simply pointing out reasons why it sounds suspicious- which logically would be the same suspicions MetLife had. Take his advise from his first response, and pour money to a lawyer if you so choose to.

  1289. May 5th, 2012 at 2:40 pm #Tasha H

    I was not getting upset but the remodeling was done in 2010 the house did not start foreclosure until may of 2011 the fire report says that the cause under investigation the fire chief stated it could have been electrical or from the water heater I’ m not sure we just received the decision today about the claim being denied I’m just trying to find out what options I have because the fire was not caused by neither me nor my husband and we did not instruct anyone to set the fire either

  1290. May 5th, 2012 at 2:49 pm #Jason

    Tasha,
    Did the person who remodeled leave other tools and supplies or was it just the paint thinner? Specifically, what remodeling did he do to your home? Did he do painting?

    We are asking these questions to get an idea where you stand with this issue. You seem to be focused on the cap of the paint thinner. There is so much more surrounding a fire loss than the actual flames.

    If you have a person remodeling, it is very likely that you had a person working on the electrical issues you described. Is that correct? What kind of work did your electrician do, if any?

  1291. May 5th, 2012 at 3:24 pm #Tasha H

    There was nothing left and the electircity was not even on in the room he remolded he enclosed the carport and turned it into a den but he was finished with that and he had left some paint thinner in a corner in the room that was turned into a den and my husband said he just put it on the cart in the laundry room to get it out of the way of putting furniture in the room I don’t know what to do now I just need some advice I’m not working now only my Husband is working and we really can’t afford and an Attorney we have to pay upfront

  1292. May 5th, 2012 at 3:28 pm #Tasha H

    he did do painting because he enclosed the garage but all of this was finished in feburary and he was coming back later to hook up the electricity but we were not worried about that at the time because the light fixture was already installed and we could turn the light on and off from the inside wall switch we had furniture out there but not a television because it was only going to be used as a sitting area sometime

  1293. May 5th, 2012 at 3:32 pm #Tasha H

    they are saying the fire was incendiary and neither me or my husband had anything to do with it I don’t know what we are going to do but I intend to get and appeal filed some kind of way because this is ridiculous

  1294. May 8th, 2012 at 11:01 am #Jason

    Tasha,
    It doesn’t make sense for your husband to move paint thinner from an unused room where it is conveniently in a corner to a laundry area that is used frequently. In fact, a paint thinner is more appropriately stored in the garage/sitting area because it’s flammable.

    I would consider this arson from the information you have provided. First of all, this is 2012 and most paints used now are water-based paints and to thin a water based paint, you simply add water. For a modern day painter to even consider using an oil based paint is hard to fathom. Paint thinner is not needed to thin water based paint. Paint thinner is useless to clean-up after a water based paint.

    Ok, here is the your situation. You can hire an attorney for a bunch of money. There are 2 results. He could find that you guys didn’t burn your place and the insurance money gets paid to the bank and you receive nothing. You very likely won’t get attorney fees reimbursed. You might also get some or all of your personal property paid for.

    The other result is you pay your attorney a lot of money and you are found to have caused the fire. Your bank will still get paid what it’s going to be paid and you won’t have any insurance money for personal property. You will have paid a lot of money to the attorney and may still owe him more.

    You can consider our perception of this entire situation the same as what a judge or jury would think and based on what you have told us, we agree with the insurance company and believe your husband and/or you caused the fire.

    While you might not be involved in the fire, it is likely your husband was because his intimate knowledge of the paint thinner, it’s placement, it’s missing cap, etc. Statistically, most people who set fires are males. Although this is speculation, the last attempt at setting the fire with electricity didn’t work so that is why something flammable was used this time. You may want to look at “innocent co-insured” if you had nothing to do with the fire.

    On other thing. One of your prior posts indicate the work was completed in 2010 but you just said he finished in February of 2011. Credibility goes a long way when facing these type of accusations.

  1295. May 8th, 2012 at 8:28 pm #justme

    Tasha,

    Pay close attention: If you or your husband had nothing to do with the fire being started, then your insurance company can’t prove you did. In other words you can’t prove something that didn’t happen, which is exactly what the insurance company needs to do. If they can’t prove you or your husband is guilty of arson or paid someone they have to pay you or get sued. It don’t matter if it looks fishy or not. All arsons look fishy to an insurance company, but it is covered in your policy. People on here can say all they want about how it looks, but fortunately in this country you have to prove it. Now, with all that being said you can find a lawyer to take your case on a contingency fee to help settle your claim. You MAY have a potential “Bad Faith Claim” against the insurance company. I don’t know enough about your claim to dictate that though. Find a lawyer in your State that handles this kind of case. If a lawyer takes your case, then more than likely you will win. If you can’t find one let me know and I will help you find one. Just let me know what State the loss took place. Your mortgage being late has absolutely nothing to do with anything. They cannot deny your claim because of your financial situation. Your financial situation may motivate them to investigate, but that is all.

  1296. May 8th, 2012 at 8:55 pm #Jason

    Justme,
    All cases of arson don’t look fishy to the insurance company because arson is the intentional burning of owned property. That’s not fishy, that’s burning your property to collect insurance money.

    Please don’t indicate arson is included in an insurance policy. It’s not. Insurance companies do not cover intentional acts of damage.

    There is nothing about Tasha’s situation that remotely comes close to bad faith and for you to suggest that is careless.

    Also, if a lawyer takes their case, the only thing for sure is the attorney will take their money in fees and their case, with the information we learned, will not be successful. There is no attorney is this country that would that this case on a contingency basis. Please understand what contingency means and why an attorney would not work for free because the end result of this situation is obvious.

  1297. May 8th, 2012 at 9:17 pm #Kari

    Jason I couldn’t agree with you more. Home in foreclosure, remodeling completed in 2010, paint thinner left out in 2011…. I’d be really curious what the fire Marshall report states…

  1298. May 8th, 2012 at 10:04 pm #Charlene

    Jason,

    Well we are in the home stretch now with our water and mold claim on our cabin in Yelm. It has been over a year now since this whole rebuilding ordeal began.
    Finally in December our contractor submitted to Safeco his final invoices for the job, which Safeco approved and forwarded a check made out to us and our mtg company. Like the other checks submitted it was forwarded back to us from our mtg company made out jointly to us and our contractor.

    Now last week almost 5 months later we received a new “final” invoice from our contractor which he also submitted to Safeco for almost $5,600.00 of additional funds…many items he stated were ommitted from the previous re-cap sent to Safeco accidently. Here is my question, the contractor has stated if Safeco doesn’t pony up we are responsible for this latest bill…ugh to say the least, but since we went with the contractor suggested by Safeco and since our adjuster was giving the yay or nay as the process proceeded how can this be possible?
    Also if we are stuck with this bill, then am I at least able to submit it to Safeco to recoup almost the full amount under our depreciation originally subtracted from those initial buidling funds?
    Any advice would be appreciated,
    Thanks ever so much Charlene

  1299. May 9th, 2012 at 5:15 am #Tasha H

    Thanks for the advise I have contacted a lawyer that is going to look into my case and I have faith in GOD that everything will work in our favor because I know we did not start the fire or instruct anyone to start the fire they just want to say that because they found a paint thinner can in the laundry room after the fire we don’t have a garage so that is where it was stored on a utility cart who would start a fire and leave evidence that’s crazy but we will fight this situation until the end The lawyer we found use to work for insurance companies doing the investigation and EUO and these are the type of homeowner claims he handles claims denied where the insurer claims the homeowner burns their house down to collect monetary benefits and for Kari and Jason we will find out the fire Marshall stated it was due to electrical issues from the breaker box in the laundry room and I got faith that we will come out on top in this issue because when Man says no GOD says yes and I am a firm believer in this Thanks for all the comments I will be posting the outcome when every thing is settled

  1300. May 9th, 2012 at 5:22 am #Tasha H

    And Jason I did not read your full comment that room was finished and it was being used and when you have young children around who would want paint thinner where they could get into it and it was not in a corner since we don’t have a garage we always store stuff in the laundry room its big enough to store anything in there that we want too who can tell someone where to store stuff in their own home And for your information I was the last one to leave the house my husband was at work you Jason are assuming things that don’ make any sense so what you are saying anyway the person that remolded our house I don’t know what he used the paint thinner for so don’t go making accusations

  1301. May 9th, 2012 at 5:26 am #Tasha H

    The cap was only missing because it was plastic thank you we did not attempt to set anything while you are saying the last attempt to set a fire did not work YOU NEED JESUS I’m not even going to let you get under my skin because your comments are not worth it HAVE A GOOD DAY

  1302. May 9th, 2012 at 6:21 am #Jason

    Charlene,
    Let your insurance company know about this and ask them what they want you to do. I don’t know the details but sometimes there are overages that occur with almost any job and it seems reasonable that it should be paid unless there was work done that went beyond what you had before.

  1303. May 9th, 2012 at 7:06 am #Jason

    Tasha,
    You first report the paint thinner can is in a corner. Then after I comment about that, then you say the paint thinner was not in a corner. The thing is that you don’t know anything about this paint thinner. Everything you know about it is information your husband told you about it. Yet, you are telling us information about it like you know first-hand. Sometimes the best answer to provide is, “I don’t know”.

    You say the “room is only going to be used as a sitting room sometimes”. It doesn’t have electricity and a television. That is a suggested future use of this room. Yet, then in follow-up, you say the room is used. That is different from, “going to be used”. Remember, children don’t “sit” – adults do.

    You say you put a load in the washer and the dryer was “going before we left.” That statement indicates your husband and you left at the same time (together). But in your recent post, you indicate, “…(husband) was at work” when you left the house. A judge or jury will interpret these statements as inconsistent because that is actually what they are.

    We are not assuming anything. You are saying one thing and then later saying something very different.

    A cover will melt and there will be melt residual on the can. That is something easily identifiable. On the contrary, a missing cap will leave no melt residual on the can.

    Incendiary data is collected from a wide area in and around the origin of a fire. Paint thinner, even after burned, provides measurable markers to identify where it was before it burned.

    If you want feedback, you are going to get all the realistic and no-nonsense feedback we can provide. Not all the feedback is going to be rosy and tell you this is going to be all right when everything you provided supports a different conclusion.

  1304. May 11th, 2012 at 12:11 pm #Alex and Matt

    My boyfriend’s house was robbed while he was incarcerated, are there any provisions in a homeowners insurance policy that would deny his claim based solely on the fact that he was incarcerated????

    Thank you!!

  1305. May 11th, 2012 at 12:18 pm #Jason

    Alex,
    Yes, if the property is vacant or unoccupied for 90 days, several causes of loss are removed – and vandalism and theft seem to be a common ones that are removed because the chances of a loss increase the longer a place is not lived in. (The house could not be robbed unless someone was present. Robbery is done with the victim present.)

    It doesn’t matter that he was incarcerated. It is based on how long no one had lived at the home.

  1306. May 12th, 2012 at 10:16 am #justme222

    Jason,

    Arson is when “someone”intentionaly sets a fire. that doe’s not mean that the homeowner had anything to do with it, nor doe’s arson dictate insurance fraud. I am not surprised at your comments though, as you have been very misleading and disrespectful in the past. I see that you have still not been humbled….shame on you, but I’m still praying for you. I am “done” and you are “d__b”

    Furthermore: I think Jason works for the insurance companies or something. Something is not right with this dude. This is not the first time or the last he has given bad advice. The sad part about it though is that I really think he knows better that what he is telling people. Maybe the shady insurance companies is paying him to mislead people. just a thought

  1307. May 12th, 2012 at 10:25 am #Jason

    justme,
    Yeah, that is what arson is all about – it’s when someone intentionally sets a fire. In Tasha’s case, it’s arson committed by the property owner. When one burns their property and submits a claim, it is insurance fraud.

    You sure have some good conspiracy theories. Just realize we post solid and straight forward information on here. If you don’t like the way it is, too bad. We are not going to make it more palatable for you because you can’t handle the sometimes disappointing truth.

  1308. May 12th, 2012 at 2:29 pm #Marcie

    My father in Nebraska had a pipe break in his basement that caused a flood to the entire basement area; Nov 2009. His insurance company paid for replacement of carpet and came in a put fans and sprayed some ‘mold prevention’ stuff around at time of this claim. My brothers was doing some painting in this same basement this last week and pulled a damage piece of paneling away from the way and apparently when this flood occurred this paneling and the insulation behind it got wet from the floor up about one and half feet and there is mold all over behind this paneling now traveling up the walls. So the adjuster, apparently did not see that the water did damage to this paneling and now all this paneling that got wet is not molded and has to be pulled out and all this mold has to be dealt with. Can the old claim be reopened for this damage cause by the original water damage? My Dad and many in his town have changed insurance companies since then due to big increase in premiums–lot of tornadoe and hail claims in that timeframe. Can the old insurance company be held liable for the damages cause under the original claim? We have requested all the paperwork pertaining to the old claim and the sent an adjuster to the house 2-22 and then 3-24 another who did a bunch of testing….we have asked for the adjuster’s report from 2-22-12 and paperwork from original claim and they are refusing to provide. They sent a denial letter and I have asked for process to file appeal and they are ignoring this request for paperwork and appeal process. They didn’t do a proper clean up on original claim and this is what caused the present mold issue. Any input on appeals and their responsibility based on the original claim?
    Thank you for your help,.

    Thank you for any help you can provide.

  1309. May 12th, 2012 at 3:25 pm #Jason

    Marcie,
    If the claim happened in 2009, and your father owns the property, it is his responsibility for him to see that the water damage gets addressed properly at that time – not 3 years later.

    You can appeal by suing the insurance company. You would have to prove the insurance company caused your father not to be able to clean and repair the water damage thoroughly in 2009. That would be a nearly impossible feat.

    If someone doesn’t have their home properly repaired after a water loss, you really have to apply the blame to the homeowner, not a company that paid for the repairs.

  1310. May 15th, 2012 at 12:48 pm #Arlene

    Hi Admin and/or Jason of Insurance Claim Help

    My parents recently experienced water damage due to a burst pipe in kitchen wall (behind the sink). We submitted the claim to Tower Hill Insurance and they denied the claim. I emailed you the denial letter, along with other documents submitted to carrier. Is there anything further that can be done? Can my parents fight the denial?

    Arlene Timothee

  1311. May 15th, 2012 at 2:12 pm #Jason

    Arlene,
    After reviewing the information you sent, the insurance company is correct. You don’t have coverage for the damage that occurred. It is specifically excluded in the policy by the endorsement that they referenced. It is also noted as not being covered in a summary of your coverages and exclusions.

    They can fight the denial but it will be a fight that will not be successful.

  1312. May 22nd, 2012 at 1:56 pm #Doug A

    My insurance client hired a handyman from Craig’s List to re-stain his staircase. Apparently, the handyman was uninsured (surprise!). He accidentally spilled stain on the carpet; the insurance company paid for the carpet claim less their deductible. I assume they will subrogate. The family dog was nearby and got stain on his coat and paws; he tracked the stain onto some furniture. The insurance company denied the furniture damage, even though the home policy provides “Special Form” coverage for the furniture. They used the domestic animal exclusion as the reason. Does this sound like a reasonable outcome, as the cause was the handyman’s accident?

    At this point, client plans to sue handyman for the uncovered furniture damage ($1,500) plus the deductible for the carpet claim ($1,000).

  1313. May 22nd, 2012 at 2:09 pm #Jason

    Doug,
    Here’s a way to look at it – “Had it not been for the domestic animal, the stains would not be on the furniture.” The handyman did not cause the dog to do anything. The dog acted on its own.

    So, if you take the dog out of the equation, the furniture would not have been damage regardless of what the handyman did or didn’t do.

    They can’t sue the handyman until the insurance company releases it’s claim and allows them to sue the handyman.

    If this person wants a judge or jury to find the handyman responsible for a dog the handyman had no control over, they will have a nearly impossible task.

  1314. May 28th, 2012 at 12:44 pm #Shirley Watts

    Is there a website where I can print a copy of my Foremosy mobile home insureance?

  1315. May 28th, 2012 at 2:54 pm #Jason

    Your agent should be able to supply you with a copy of your policy. You should have received a your policy when your coverage began and it might be in your paperwork you filed away.

  1316. June 25th, 2012 at 5:35 pm #John

    A hail storm on May 29 severely damaged my roof. I have Hartford (AARP) Homeowners Insurance and “thought” I had RVC. However, after talking with the insurance company, I have ACV due to an inconspicuous clause that I didn’t know about. An adjuster is coming this week to look at the roof (three layers, wood shingles with 2 layers of composition on top). The last composition layer was installed in the late 90′s and all shingles are intact and other than hail dents look pretty good. It was a 25-year shingle. I realize the replacement of the shingles is probably going to be depreciated (labor and materials), however I have had 3 reputable roofers out and each of them indicate the roof must be removed completely due to local ordinance and that cost is not depreciable – which I believe based on a Supreme Court Decision in my state. So, basically from what the roofers tell me, I can probably come out pretty good, since I have a $500 Deductible and complete debris removal in the policy. I have read on the Internet that there may be things involved such as local ordinance, O&P, etc. My question is, does this all sound too good to be true? I am somewhat pessimistic, but I want to believe it might be legit. Any suggestions or things I need to watch for?

    I posted this earlier in “General”, but thought it might be better to have it in the “Home” category. Hope this post is ok.

  1317. July 1st, 2012 at 8:11 am #Meachi

    My grandfather is getting some home repairs and remodeling done to his house. The contractor is stealing our personal property and his medications (pain pills). We know for a fact that it’s the contractor because no there is no incoming or outgoing traffic in our home but these guys. The only other people in and out of the home is me, my son, and my uncle who all lives in the home. My grandfather is presently in rehab and our family and friends visit him there. What can I do legally to get our items replace (I know we will not get the medication returned) and get our money back from this contractor because we don’t trust these guys in and out of our home?

  1318. July 1st, 2012 at 9:46 am #Jason

    Meachi,
    These contractor people should be fired immediately. You could get the police involved. You could videotape these contractors with hidden cameras to gather proof for the police.

    Any money that has been paid for the job will likely not be returned.

    When a crime has been committed, you should call the police, not write about it on an insurance forum.

  1319. July 2nd, 2012 at 2:18 pm #John

    I am in the last stages of my roof claim, however, there seems to some confusion about what is being depreciated under an ACV exclusion clause in my policy. The exclusion clause pertains to the roof only making it ACV rather than Replacement, like the rest of the house. The claims agent has disallowed about $3,000 under clause. However, before I filed the claim, I contacted the insurance company’s customer service and was told that the clause only applied if the roof was 15 years or older. (Mine is under 15 years) Today after discussing the Loss Report with the claims agent who is hitting me with depreciation for the clause, I again called customer service and the person there confirmed that depreciation only applies if the roof is over 15 years old. She even put me on hold to double check it. Do you think I have any recourse if the claims agent doesn’t change his mind?

  1320. July 2nd, 2012 at 3:13 pm #Jason

    John,
    The depreciation may apply to whatever terms are in your policy. The limitation may even apply to a roof that is over 10 years old.

    The best way to present your claim and case is to review your policy for the loss settlement provisions and the endorsement that modifies your roof’s coverage based on it’s age.

    Information is the best way to overcome this with your insurance company and the adjuster who may or may not be right about your claim.

  1321. July 10th, 2012 at 10:18 am #Ashley Young

    I am a first time home owner. I just purchased a HUD forclosure that has been vacant for over 2 yrs. There is an escrow account set up with a very small amount of money to cover “roofing”, as par the appraisal report. After moving in and getting contractors to come give me estimates, we have learned that the entire roofing needs to be replaced. It is beyond repair, and several of the estimates have said that the damage appears to be from wind and/or hail. The escrow repair money is far less than what it’s going to cost to replace the roof and get it properly fixed. Can I claim this on my homeowner’s insurance, considering the damage happened before I purchased it?

  1322. July 10th, 2012 at 11:35 am #Jason

    Ashley,
    No.

  1323. July 10th, 2012 at 7:09 pm #Insurance confused...

    Hello..I have a quick question…
    We recently had terrible wind that damaged our roof and also to our garage which we don’t think can be fixed. A family member who is a contractor gave us an estimate on the… he said he could try to patch up the garage which is leaning, roof joists pulled apart and actually you can shake the garage (hubby did it with one hand)…He said for around $8000 he could jack it up and replace all busted items…but it will never be the same..or tear down and replace for approx $9000…OUr adjuster isn’t coming until next week. If they agree to the tear down…would be HAVE to replace the garage? We were told they would give us a check for the amount they felt the garage is worth…but we were thinking about doing a car port/lawn building and possibly anything left over going to some indoor updating in our home.. We have a detached building coverage for up to $12,500…

  1324. July 10th, 2012 at 7:26 pm #Jason

    confused,
    We don’t know what your options are. Talk to your adjuster.

  1325. July 18th, 2012 at 7:32 am #Roy Forgy

    I had a fire and smoke damage to my home, insurance company recommended a restoration contractor they did an estimate and insurance company approved it. @$75,000 , about 1/2 way through the demo they decided that the two rooms they had planned to clean were in need of demo too so they sent in a revised estimate, @$85,000. Insurance co approved and work was continued.

    About a month or so prior to completion ( house was 80% complete) my agent called and said the company had decided to call it a total loss and pay me the amount of the coverage $100.000. I questioned this since the house was almost done but they would not change their mind, he told me to go ahead and finish it and it would be fine.

    Now they are refusing to renew and I can’t find anyone else who will cover it due to it being declared a total loss.

    The house has passed city inspection the mortgage company sent out an inspector and they also passed it and I am currently living in it.

    Any idea what I can do now or where I can get affordable insurance? I am retired and living on a fixed income.

    Roy

  1326. July 18th, 2012 at 9:03 am #Jason

    Roy,
    The insurance company doesn’t have to renew your policy. I find it rare that you can’t find anyone to cover your house. It’s likely you haven’t checked with other insurance companies. You might want to do that. You as well as I know your house is not a total loss. Your mortgage company knows it too. Anybody using some reason and a little bit of thought will know it’s fully repaired and insurable.

    If you get higher insurance because of a fire loss (and any other losses you may have had), the extra $15,000 above what it cost to fully repair your house should cover the minimal increase in premiums. Your fixed income should not be any concern relating to your new premium.

  1327. July 18th, 2012 at 9:29 am #Roy Forgy

    Well the first two I contacted said they would not insure it because it had been classified as a total loss by my current company.

  1328. July 18th, 2012 at 9:34 am #Jason

    Roy,
    There are literally thousands of insurance companies out there. You checked with 2. There are thousands more to check with.

    Did you complete an application with those first two insurance companies? Because if it’s being denied by underwriters, then there are more concerns than just a damaged house that has been fully repaired.

  1329. July 18th, 2012 at 12:10 pm #Kari

    My guess is that it is being declined due to the cause of loss, not the fact that the loss happened, but the actual cause of the fire. I know the 6 home insurance companies that my agency represents will not offer insurance on a home that has had ANY type of negligent fire loss- What does the fire marshall report say caused the fire? Is this your only claim in the past 5 years? I agree with Jason, there is more to being declined than just have a total loss.

  1330. July 20th, 2012 at 6:42 am #Eileen

    If we own a home (no mortgage) with an illegal apartment in it can we get homeowners insurance? Secondly and just as important if anything happened down the line would the insurance company be able to deny our claim strictly because the apartment was illegal?

  1331. July 20th, 2012 at 7:25 am #Jason

    Eileen,
    In order to provide an answer to your question, we first must understand the question. We don’t know what you mean by an illegal apartment. Without knowing what you are asking, we cannot provide a reasonable response.

    It would seem if you had an illegal apartment within your home, that would also make your home illegal. However, we don’t know what makes the apartment illegal so we will await clarification.

  1332. July 20th, 2012 at 9:15 am #Johnny

    Damaged fence thrown in with damaged detached garage payment.
    Does the homeowner policy cover the fence as A-dwelling or B-Other Structure? The fence was attached to the house, not the garage.

  1333. July 20th, 2012 at 9:43 am #Jason

    Johnny,
    A fence is another structure. It is clearly coverage B regardless if it’s attached to your house, a truck, or a couch.

  1334. August 1st, 2012 at 9:44 am #Liz

    My husband and I are looking at purchasing a house which has a non-conforming ADU on premise. It is a separate structure with it’s own electrical meter.
    We know the previous owners rented it out and intend to as well ourselves.
    I am curious how home owners insurance could be impacted by this. I assume our insurance would cover the structure as it is listed as a separate structure on the property and that the rentor would obtain a policy for their personal property? Could there be any issues with either potential claims down the road for example if a fire occurred.
    Years back I rented an attached mother-in-law unit and was told I was covered under the home owners policy due to the fact it was attached.

  1335. August 1st, 2012 at 10:27 am #Jason

    Liz,
    We believe you would need a dwelling policy for the separate structure if its a rental structure.

    We cannot predict the future and any claim can have issues so to ask that blanket question will only yield a blanket answer.

  1336. August 7th, 2012 at 5:11 am #Dan

    What a great website, thank you. My home has some minor damage in the Colorado wildfires 5 weeks ago. One of the things damage was my pond which is now leaking. Is that considered part of the landscaping portion of the policy? I also have 100’s of trees burned from the fire so I will max out on the policy limits for my trees. My question is if the pond liner repacement is part of the landscaping allowance it really dosn’t do me any good to get bids since I am maxed out on policy limts for my trees. However if is part of the other structures or some other part of the policy?

    Thank you

  1337. August 7th, 2012 at 2:20 pm #Jason

    Dan,
    There are the kinds of questions you should be asking of your adjuster, insurance company, or both.

  1338. August 14th, 2012 at 3:41 pm #James Tigh

    Have a windstorm claim in NJ. Allstate is the insurer. They paid part of the claim and I am fighting for the rest. The initial estimate did not include O&P even though there are 3 + trades involved. When speaking to the inside adjuster he stated that Allstate does not pay O&P regardless of how many trades are involved. Can they do that ? Is there any law to backup my claim that O&P should be paid? I am in New Jersey and trying to get some guidance on how to backup my argument.
    Thanks.
    James

  1339. August 16th, 2012 at 1:12 pm #Michelle

    I was involved in an accident. At a lady’s house and her dog jumped on me and I fell off the pocrch and landed on some big rocks and a Dolly. Well my neck and my back where hurt and I went to doctors and hospital and now my doctor will not help me until I start physical therapy but I can’t afford my physical therapy and I can’t barely work due to severe back pain and now the insurance Co wont offer me anything other then $2000 for physical therapy and to pay my hospital bill but that’s it. I have lost a lot of work and time with my family I had to cancel my family vacation can not sleep at night without meds to put me asleep. My back is constant burning . What do you think I should do

  1340. August 16th, 2012 at 2:13 pm #Jason

    Michelle,
    There should be medical payment coverage available to you for your treatment usually up to a certain limit depending upon what coverage limit the homeowner has elected to carry (commonly $2500-$5000). Generally that’s available without regard to liability – it’s there for people that get injured on an owner’s property. The other aspect of it is if she’s liable for your injury (because of her dog) and that would be a liability claim. We don’t have all the details of this incident and even if we did, it’s probably something only an attorney can sort through for you.

  1341. August 18th, 2012 at 2:36 pm #Rich

    We had a toilet backup and cause extensive carpet damage on that level and drywall damage below it downstairs. When it flooded initially my wife called roto-rooter and paid 437 dollars to have the drain cleared. shouldn’t have this been applied toward my 500 deductible? The person who first processed the claim and was aware of this and was provided a receipt number.

  1342. August 18th, 2012 at 2:48 pm #Jason

    Rich,
    That sewage water may damage things that it comes into contact with, but you’ll have to understand that the clog in the pipe is not any damage caused by your toilet overflow.

    You have to look at it this way – Did the water overflow cause the pipe to clog? OR did the clog cause the toilet to overflow? The thing causing the damage is not covered but the direct damage from the overflowing water is.

  1343. August 20th, 2012 at 11:03 am #phillip

    a wildfire went thru our community and burnt several homes and lots. I was preparing to sell my home and now i feel it is worth nothing due to the devistation here and clean up. My home was not hurt except for the retardent on my house. this fire was started by construction company that is taking full responsibiltiy. do i have any recourse on this company that they have taken homes but also destroyed the value to my home and will not be able to sell it now?
    I would appreciate any help. The state hired the independent contractors.
    Thank you

  1344. August 20th, 2012 at 11:30 am #anne T

    We are a family of 5 and we tragically lost our home in November 2011. At the time of the fire, my children were 5,4 and almost 8 months old. The night before the fire we were having problems with our heat pump and it was not kicking in like it should…leaving the house a bit cold. The next morning my husband told me he turned on 2 space heaters in the home before he left for work around 4am. So, I get up and start getting ready for the day…the home is chilly and I can’t get the heat pump to work correctly and the power goes out in the home…I never went downstairs to fix it, I was just going to call the heating men to come fix it..So, I lit a candle to go upstairs to get socks for my girls and come back down…get them all ready and leave..I dropped my oldest off at school, ran a few arrends and came home…We left a bit before 8am and came home a bit after 9am…the house looked fine…cats were still sleeping on the steps and i opened the front door and the smoke poured out of the house…I called 911 and the fire dept. came and put out the fire…they said it looked like it came from the basement…I never even thought about my candle…I thought it was the furnace…I did tell the insurance co about the candle when we were interviewed…and I thought I put it on the table and blew it out…Later on my 4 yr old stated it was on the highchair and lit…if u go in the home…the highchair is gone…completely burnt and gone and there is a huge hole in the floor where it was…I also needed to take the garbage out and it was in the same area and that gagage was gone too…so It was pretty obvious what had happened…it was an accident caused by me with my candle…State farm says no it was not an accident and someone it the home lit the fire from the basement…nobody was even in the basement and my husband was gone for 4 hours before the fire…so the only person that could do it was me…I am 5ft tall and have 3 kids that are always at my side…I did not do it and they will not listen to reason…they think it was lit up in the floor from underneath…and the ceilings are around 8ft tall with no ladder…and if it was lit…I would have to go under it again to get out…it is impossible..we have been investigated since the monday after the fire in November…and finally we got the letter stating why we were denied this week…

    here is a bit more background…the day of the fire…the firefighters brought out some baby pictures, some wedding pictures and so on from the home…they put this all in the back of my van…along with the family computer…we brought this all to My husbands fathers home and some of it we stored in a trailor we had on our farm…We took the computer components out of the computer to bring to my brother to save some pictures if they could be saved…we pulled pictures out of frames to save some of them and took some baby blankets and dolls from my girls beds…We were forced to move again and again after this fire and lost a lot of clothing and the computer parts…we did donate a lot of clothing and toys to thrift stores afterwards too because we were so overwelmed with donations from our church and friends in our community. We were told that they wanted the computer and we told them we misplaced the parts but we will look for them when we unpack…we never have found them along with a bunch of pictures, and clothing that we had purchased…and they knew about this in December of 2011.

    So, in the letter of denial…they said we are denied because we withheld the computer parts…We can’t give them what we don’t have. and it states they feel someone in the home started the fire…but, they do not know who or how. They denied the claim entirely. We are left with no home and do not know what to do next. They were paying our rent during this time and that is all…We have had to move to 3 differant homes since the fire and it is so rough on our babies…now we have to move again and we do not know where to go…we will be homeless soon and are terrified. I am so scared for my children. We promised them they wouldn’t have to move again until we get to go home. We lost everything … our home, first haircuts, baby books, baptism gowns, wedding dress, savings bonds…u name it…its gone…things that cannot be replaced we will never get back and now we have no place to call home as we were denied. Our claim was small and after this we found out we were not even insured for enough…we are honest people…and did nothing to deserve this…
    We were recently told that if our morgage company requests payment they have to pay them…but, will the ins.company own our farm? or will they sign over the farm to us?
    do we have a case? we are so lost and have no idea what lawyers to call…
    we are in Minnesota
    also, all of our bills were paid…we were not behind on them and there is no motive…

  1345. August 20th, 2012 at 12:03 pm #Jason

    To both Anne and Phillip,
    You will need to discuss the details with an attorney.

  1346. August 30th, 2012 at 9:58 am #Melissa

    My mom owns her house and her insurance is sky high because of a claim her EX husband filed on his house that her name isn’t on, but she was on the policy for her car. Her insurance company is telling her she is be penalized for the 8 years because of this. Is this legal? The claim was for $500 for something someone broke in an stole. She lives in SC and so does the ex, any information would be helpful. I’m mainly looking for someway for her insurance to come down to where it should be…. The insurance company has told her it would be around $850/year if this claim was not hurting her. Currently she pays a little over $1500/year.

  1347. August 30th, 2012 at 10:13 am #Jason

    Melissa,
    There are hundreds and hundreds of insurance companies that provide homeowner’s insurance. Rather than looking at what it could be with this specific insurance company, your mother should shop for insurance among all the other companies that provide premiums based on different rating structures.

  1348. September 16th, 2012 at 12:33 pm #Toni Jessen

    Bought my deceased fathers home in 2010. The executor of the estate (sister) had the homes plumbing pipes under the house replaced bcause they were cast iron and had deteriorated and sank. The work was done 5 mnths prior to my purchase. We closed on the house and knew that mold began in one bathroom/bedrm and assumed it was due to the house being empty and the a/c not set properly. We decided to remodel the problem areas etc. We pulled the bathtub out & found a hole in the concrete floor which led to a cave running from one end of the house to the other. This cave approx. 4 ft by 6 ft was left by the plumbing co. Immediately realized an extreme amount of moisture/humidity coming from below the slab.
    My husband (construction background) noticed immediately that one of the grade beams had been damaged due to improper installation of plumbing sleeve. The other conditions found were that the vapor barriers throughout the cave had been ripped in many spots, massive condensations dripping from pipes, accumulated water, bugs etc. Later realized that the soils around the perimiter of the house would drain under the slab with heavy rains causing severe erosion.

    We are new to Florida so dealing with homes on piles are new to us. From the time we found the cave we began trying to find out exactly what the plumbing co. did, what the codes for the city & state were, inspections, and homes on piles etc. In addition, we sought opinions from 3 engineers.

    To quickly summarize we did absolutely everything to get help. Contractor refused assistance, permits were found to obtain false information, city inspector did not inspect, city refused to answer questions all of this going to the state DBPR. Engineer consultants hired and we obtained a report that provided documents to show that plumbing company damaged 6 grade beams, ripped vapor barrier when excavating, and did not return the excavated sand under the home leaving this cave to accumulate bugs, water, moisture etc. Additionally the soils around the home were seeping under the slab causing erosion problems.

    We pursued the problem with the county Contractors Licensing Dept. and to the contractors insurance to no avail. After being declined help I turned into my own insurance carrier Universal and just received a denial.

    The denial stated several reasons.

    1- Damage occurred 5 months prior to policy coverage – We hired an
    Inspector prior to purchase and he had no way of knowing about the
    large void under the house.
    Universal included wording that states:
    Also, had known pre-existing damage issues been disclosed at the time
    you signed your application for insurance, the following endorsement
    would have been presented to you.
    Under UPCIC 10 04 91 Existing Damage Endorsement
    I did not included the endorsement but I can quote if needed

    2- Coverage A Dwelling & Coverage B -other structures
    We insure against risk of direct loss to property descibed in
    coveragesA & B only if that loss is a physical loss to property. We
    do not insure for loss: caused by (6) ***Settling, shrinking, bulging, or
    expansion, including resultant cracking, of pavements, patios, foun-
    dations, walls, floors, roofs or celings,***

    3- Section 1 – Exclusions (page 9) –
    c. Faulty, inadequate or defective
    (1) Planning, zoning, development, surveying,siting;
    (2) Design, specifications, workmanship, repair,
    construction, renovation, remodeling, **grading** compaction**

    Do I have any recourse with these denials.

  1349. September 16th, 2012 at 1:52 pm #Jason

    Toni,
    The reasons for denial seem to be right on. There was not an insurable event that happened while the policy was in effect.

  1350. September 16th, 2012 at 7:01 pm #Toni Jessen

    Jason,

    Thanks for the quick response!! I have an alternative option (I think) and would like your opinion.

    Quick background on the purchase of my dads house. I bought it from my dads estate through the executor (my sister) but lots of bad blood, we don’t talk, and she would not help me in any way with this dilemma. The insurance company that insured my dads home until the day I purchased was State Farm Ins. but I don’t have the policy number. May not be relevant but my two sisters and I were equal beneficiaries to everything and one sister was the executor.

    If I’m going to get help from any insurance it would be the company that insured the house when the work was done. Do you agree?

    If I’m right though would SF deny it anyway by stating they don’t insure for the same reasons that Universal stated such as
    2- Coverage A Dwelling & Coverage B -other structures
    We insure against risk of direct loss to property descibed in
    coveragesA & B only if that loss is a physical loss to property. We
    do not insure for loss: caused by (6) ***Settling, shrinking, bulging, or
    expansion, including resultant cracking, of pavements, patios, foun-
    dations, walls, floors, roofs or celings,***
    3- Section 1 – Exclusions (page 9) –
    c. Faulty, inadequate or defective
    (1) Planning, zoning, development, surveying,siting;
    (2) Design, specifications, workmanship, repair,
    construction, renovation, remodeling, **grading** compaction**

    Here is one final thing. If all else fails could I/should I send a letter to State Farm providing all the information that I have uncovered and ask for them to reconsider based on the fact that not only did they insure my dads house but he was also a retired State Farm agent with 35 years of service and ask them to assist based on that??? It may be a long shot but I think it’s worth asking your opinion.

    Thanks,
    Toni

  1351. September 16th, 2012 at 7:27 pm #Toni Jessen

    Jason,

    Would any of the ebooks apply to my situation?

    Toni

  1352. September 16th, 2012 at 8:49 pm #Jason

    Toni,
    The insured under the prior policy was the executor. They no longer have an interest in the property and that insurance is for their benefit, not yours. This clearly is not a liability situation because the executor did nothing wrong and any chance of finding negligence with the prior owner is very remote.

    Sending something to State Farm would not benefit you at all. It seems the issues are related to exclusions and also the contractors that did the work. It’s very, very difficult to hold a contractor’s insurance responsible especially since the property has already changed hands from the owners of the property when the work was done.

    I don’t believe any ebooks would benefit you because any type of recovery for you is out of reach.

  1353. September 17th, 2012 at 6:34 am #Toni Jessen

    Jason,

    Thanks again for the quick response it is much appreciated. I do, however, have a question pertaining to the contractor.

    Why is it so difficult to hold the contractor’s insurance company responsible? The damage to the grade beams, vapor barrier etc. is proveable because they were the ones that excavated underneath and no one has been under the house since the day it was built some 30 years ago.

    Again, thanks so much,
    Toni

  1354. September 17th, 2012 at 9:20 am #Jason

    Toni,
    You said the contractor’s insurance company already denied your claim. Denials are rarely changed.

    You indicate the damage to the grade beams and vapor barrier is provable. The damage part might be easy to prove. Proving the contractor’s did the damage is a little more difficult.

    You say the contractors are the only ones that were under the house since it was built. The contractors insurance company will establish when you purchased the home in 2010 and that you don’t know of any activities conducted under the house between 2000 and 2009 which is when they will insist the damage occurred. Remember, they don’t have to prove when the damage occurred and who caused the damage because the proof burden is on you. You would then have to prove that someone didn’t damage those items between 2000 and 2009. This is an just an example to illustrate that “proving” something is difficult. Our understanding of proof is not the same as legal proof.

    It seems like you don’t have an attorney working for you but if you wanted to pursue this, you would need an attorney and at $200/hr. for countless hours pursuing this for you, there is a slim chance that you would prevail. Let’s say you can prove this and are allowed damages for the moisture barrier and beams. It is very unlikely you would recover your cost of the attorney. The other extreme is not recovering damages for the beams and the moisture barrier and still having a large attorney bill.

    Another angle the contractor’s insurance could take is they could say there is damage to the vapor barrier and beams that their agreement with the people who hired them was that damage to those items was going to occur and the damage was done with permission. If you are not on good terms with the executor, you have to know this is a possibility.

  1355. September 30th, 2012 at 6:41 pm #Mary Brian

    In one post you mentioned A “Proof of Loss” can also come with hidden “traps”

    Can you please specify what traps exactly.

    I filed a claim almost one year ago and the insurance company has finally made me an offer. However, they have asked me to sign a “Proof of Loss” which I find very strange because I signed several forms when the claim was initially made and they seem to say the same thing.

    What should I be wary of?

  1356. September 30th, 2012 at 6:45 pm #Jason

    Mary,
    I don’t believe anybody in this forum told you there are traps in a proof of loss.

    A POL is simple a document that formally states your claim. It simply states “we have a claim cause by whatever cause of loss, that occurred on such-and-such a date , the total damage is $$, and we clarify this is the total amount owed to us because of the insurance contract”.

    It’s basically used as a receipt document especially when there are a number of payments made over a period of time because there may be a number of proof of losses submitted.

    There are no traps that we are aware of. However, someone making a false claim may think twice before submitting a document of this sort.

  1357. October 2nd, 2012 at 7:34 am #SB

    I live in the state of Pennsylvania with my domestic partner and two children. My domestic partner set fire to the house and caused severe damage. She is currently in a treatment facility and the children and myself are residing at my families home. We are both on the deed and insurance policy. The claim is still under investigation. Do I have any legal rights to a percentage of the claim to be covered at the least. No one was home at the time except her and I had no knowledge the event was going to happen.

  1358. October 2nd, 2012 at 8:05 am #Jason

    SB,
    The situation you just described concerns you as the innocent co-insured. The view by the courts is still moving toward a position that your interests of insurance are more important than the wrongful insured’s actions of damage. Not all situations are the same and court’s rulings vary in different states.

    You do have legal rights but that is going to depend on the views and application of the laws that your insurance company will apply. They may or may not provide coverage to you. In one extreme, you may have to hire an attorney and sue for coverage.

    If you want more information, type “pennsylvania innocent co-insured” in a google search engine and the article that you should find is entitled, “THE BATTLE BETWEEN THE COURTS AND COVERAGE…” And displays the words, INNOCENT CO-INSURED, in the search results. The article is on the website finemanlawfirm (dot) com That article will provide a lot more detail than we can in this forum.

  1359. October 9th, 2012 at 12:31 pm #CW

    Hello,

    I have a newer TV that was being moved during my move. I noticed a crack in the screen and went to turn the tv. This only furthered the damage more. I don’t really know what happened to the TV originally but it is not in working condition. The TV is samsung 65inch LED tv purchased back in december of 2011.

    Would the accidental damage be covered under my renters insurance policy? if so, how can i approach this situation without getting my self into a situation where i have a $3500 paper weight?

    thanks!

  1360. October 9th, 2012 at 12:54 pm #Jason

    CW,
    Based on the coverage of almost every single homeowner or renters policy, your personal property is covered anywhere in the word.

    The thing that is necessary for coverage to apply is that the damage to the tv must be a covered cause of loss. It doesn’t matter that the damage happened during the move because of the worldwide coverage but the damage to it needs to be covered by the policy.

    The items that can cause the covered damage generally are the following: Fire or lightning, Windstorm or hail, explosion, Riot or civil commotion, Aircraft, Smoke, Vandalism or malicious mischief, Damage by Burglars, Falling Objects, Weight of ice, snow or sleet, Accidental discharge or overflow of water or steam, Freezing, Sudden and accidental damage from artificially generated electrical current, or Volcanic Eruption.

    Please note that the “falling objects” does not apply to the the object that fell. For example, if a tree fell on the tv. The tv would be covered but the tree would not be.

    Your policy may be an all-risks policy and that means that the tv would be covered for all risks except the items in the policy that exclude coverage.

    You may want to review your policy to see what kind of coverage you have.

  1361. October 12th, 2012 at 8:26 pm #William

    I had a fire and have been paid ACV for my contents. Can I purchase a like kind replacement turn in the receipt to recover depreciation and then return the item to the store?

    Thank you

  1362. October 13th, 2012 at 8:13 am #Jason

    William,
    The scenario you described is considered fraud and we would suggest you didn’t do it.

  1363. October 15th, 2012 at 8:57 pm #Melonie

    I have been with my insurance carrier for 20 years and I have never made a claim. Recently my water heater leaked everywhere and I had lots of damage. The adjuster is approving much of the work which will be demolition of the bathroom, all drywall replaced in utility room and laundy room , trimming – etc., and replacement of all the bottom kitchen cabinets, but the adjuster will not match my upper cabinets with the new cabinets I will need to install. These cabinets were from 1970 and are impossible to match.

    I do have the full value coverage replacement; actually I was told by my agent at American Family that I have the best homeowners insurance that they offer. But they will not match my cabinets and they have only offered me $4,500 for all of this damage claiming that I can buy the materials and pay the labor with this amount. My estimates are well over their offer. Do you have any suggestions on how to make them match my kitchen and not look like a circus, and how would I go about making them pay the amount the estimates came to?

    Thanks so much….

  1364. October 16th, 2012 at 4:11 am #Tracie

    Hello! Thank you in advance for your time in reviewing my question and for your response.

    I purchased our homeowners policy 2004. By the time our house burned in 2012, the content limits was 125,000 and included replacement cost. The adjuster came and took inventory of the entire house – mostly she just bundled the items (ex 45 boys shirts, 105 books, 181 dvds, boys jeans, womens jeans…ect) and a very few items she would name the brand- 3 pairs of CarHart jeans ..
    When I recieved the inventory list with the RCV/ACV amounts, my mouth dropped. We had already replaced some of the clothes (we lost everything in the fire) – she was very good to us by paying 7.00 per fork and 8.00 per pair of socks — but only gave 10.00 for boys jeans and 20.00 for adults jeans, 10.00 for new dvd’s, 20.00 for computer software!! When I called to complain about the amounts, I cannot even buy jeans at walmart for 10.00, she said that is standard for what they give and they do not pay to replace designer jeans — we do not wear designer jeans, but we dont wear walmart jeans either — my jeans (American Eagle) cost me 29.99-39.99/ boys 16.99 – which I have reciepts for. But the items where she listed the brand name, she gave more.. a little more . 40.00 for nikes – yet the cost me 60.00.
    When all was done – the max on my RCV contents was 80,000 —
    My question is — with 45,000 still in limbo for what my policy covered, how do i get them to pay to replace what we had! Out of a 125,000 policy that I paid for 8 years, I cannot even buy 1 pair of pants without it coming out of pocket. And I don’t even want to get started on my living furinture — italian leather couch and overstuffed chair – we paid nearly 8,000 for it 10 years ago – she priced it at walmart (who doesn’t even carry real leather anything!!) for 2,000!! I am so upset, how do I get the rest of the money to cover the items I have receipts for to cover what we paid to replace??
    Thank you — Tracie

  1365. October 16th, 2012 at 4:16 am #Tracie

    Forgot to mention my insurance company is Travlers Insurance of South Carolina.

    Thanks!
    ~t*

  1366. October 16th, 2012 at 7:31 am #Jason

    Melonie,
    You post 2 questions. One is about matching and the other is about estimate differences. Your policy provides coverage for direct damage. If your wall cabinets weren’t damaged by water, then they don’t have to be replaced. Do your best to replace the bottom cabinets so they look fairly close to the ones on the wall. And try to stay away from extreme, bright multi-colors in your kitchen because that will make it look like a circus, not the new cabinets.

    Send the estimate that is more than insurance paid to the insurance company and have them reach an agreed repair price with the contractor that is going to do the work. That will make it so there is no difference in what the insurance pays and what the contractor charges.

  1367. October 16th, 2012 at 7:42 am #Jason

    Tracie,
    With the handful of items that you have concern over such as the jeans, shoes, and couch, provide information to the insurance company why those replacement allowances should be increased and provide them with reasonable documentation why their prices are too low for the items that you had. It’s a negotiating game right now and if you don’t get it changed now, you will have no chance of getting it changed later.

  1368. October 25th, 2012 at 2:14 pm #Dale

    I recently lost my wedding band that I have had for twenty seven years. Unfortunatley I was out of state when my wife took the rest of the jewelry in for an appraisal. A local jeweler has cleaned and sized the piece and is willing to give a letter of opinion as to the value(approx. $4000), as well as confirm our ownership. The insurance company says we have no claim because it was a mysterious dissappearance and was not appraised prior to loss. We live in Alaska. Do we have a claim

  1369. October 25th, 2012 at 3:03 pm #Jason

    Dale,
    Your claim of a missing wedding band due to losing it or misplacing it is not one of the 15 general coverages for personal property. The closest coverage is “theft” and since it is not theft because your claim is that you lost your wedding band, the insurance company is correct about the mysterious disappearance reasoning.

    Mysterious disappearance means you lost it, misplaced it, or something similar. This response if provided based on the likelihood that you have a standard HO-3 coverage form. The only thing that would change this answer is if you had an endorsement on your policy that provided coverage for your personal property based on “all risks” or if you had policy coverage with an all risks policy typically knows as a HO-5 policy.

    If coverage would apply for a covered cause of loss in an HO-3, or with the HO-5 policy, the maximum coverage for jewelry is typically $2500 unless specifically listed with it’s own coverage limit.

  1370. November 6th, 2012 at 1:28 pm #Ernest

    My husband and I filed claim with Louisiana Citizens back in July because our garage/extra room roof started to come in. They denied the claim because they seen water a little water damage back in 2010 when someone broke in our house. They never told has about the water damage and we use the garage/room for storage only so we never seen it until I discovered the ceiling falling. What sh?ould we do

  1371. November 6th, 2012 at 3:29 pm #Jason

    Ernest,
    Likely because of your denial, you probably have this part of the policy indicated in that denial letter why there is no coverage: Collapse means an abrupt falling down or caving in of a building or any part of a building with the result that the building or part of the building cannot be occupied for its current intended purpose.

    Coverage for collapse is spelled out in the policy and it has to be from the perils insured against for personal property, or because of the limited coverages found in the additional policy coverage of Collapse.

    If your roof is partially collapsing, and you can use the area as intended (other than the area that’s partially coming in), then it’s not covered by your policy.

  1372. November 6th, 2012 at 3:36 pm #Ernest

    They denied the claim because they seen damage( small water damage) in a 2010 claim while insecpting the house on a theif claim. They don’t tell us about the damage. So in July 2012 I noticed the damage and filed a claim

  1373. November 6th, 2012 at 3:40 pm #Jason

    Ernest,
    No, the claim is denied because it is not a covered loss. It is just coincidence that they saw the water damage a couple of years ago. Had they not seen the water damage a couple of years ago, it would still not be covered because the damage is not due to a covered cause of loss.

  1374. November 6th, 2012 at 3:54 pm #Ernest

    Maybe I’m explaining it wrong. Our damage is covered under wind damage but it was denied because we had damage back in 2010 and didn’t take the proper steps to prevent further damage. But we was never told that they discovered the damage. Is this legal?

  1375. November 6th, 2012 at 4:10 pm #Jason

    Ernest,
    When you say, “…our garage/extra room roof started to come in.”, that kind of sounds like collapse. How is wind causing this condition? And if it’s wind and it’s covered, then there shouldn’t be any issues.

    Is part of your claim covered and part of it denied?

    Your insurance company doesn’t have to alert you to damage. That is your responsibility as a homeowner. It’s not illegal for them not to tell you something and it’s not illegal for you to not observe some damage that was there 2 years ago.

  1376. November 6th, 2012 at 4:14 pm #Ernest

    Ok Thank You

  1377. November 18th, 2012 at 12:22 pm #Tammy

    I filed a claim in March of this year for hail damage with State Farm. They issued me a check for roof replacement less depreciation. My mother has since had a serious hospitilization for cervical cancer and I had not had the roof damage repaired yet and intended to repair in spring. Roof is structurally sound and no risk of leaking. State Farm canceled my policy effective the October renewal date stating for not showing proof roof had been repaired. What are State Farms time limits to complete repairs in Virginia, this was a first claim and seemed incredibly inappropriate action under the circumstances. Also can I still collect my depreciation after the roof is complete even though they have canceled me? Thanks so much.

  1378. November 18th, 2012 at 1:32 pm #Jason

    Tammy,
    Most policy limitations provide that you complete the replacement within 6 months and there is no reason that your time limit is any different than the 180 days found in most homeowner policies.

    Since the time elapsed has been over 6 months, there is no likelihood of collecting the recoverable depreciation at this point unless state farm has allowed an exception on that time period; however, it is rare that companies will do that after the time period has already expired.

  1379. November 18th, 2012 at 2:09 pm #Tammy

    Thanks for your help. Have a good day.

  1380. November 23rd, 2012 at 4:04 pm #Julie Booz

    We have Erie Insurance in PA for 7 years now. We have had 2 claims – 1 was for $525 for Loss of a ring and the other was when my dog got loose and was killed in a car accident. Apparently our homeowners had to pay for their repair. One claim was 1 1/2 ago and the other was this past April. We now have a roof that needs to be repaired due to Hurricane Sandy and Erie is telling us that 3 claims in 2 years is going to to affect our policy, but they won’t tell us how? The repair is going to be extensive. Is there anyway to find out what the penalty is for a 3rd claim and is there a way around this? Is this legal for them to raise our rates or drop us?

  1381. November 23rd, 2012 at 4:35 pm #Jason

    Julie,
    The options presented to you for your third claim will either be an increase in your premium, or most likely, the non-renewal of your policy. The insurance company can do anything with your coverage that they want just as long as they give you the required notice of their actions. The good thing for you is that there are hundreds and thousands of insurance companies out there and you will find comparable coverage with another insurance company for around the same price if you do a little bit of research.

  1382. December 5th, 2012 at 7:14 am #Jennifer

    I recently filed a claim in Virginia under Nationwide Insurance, following damage when the Sandy storm came through, for water damage in my carpeted dining room. A Cat adjuster came to the house for my claim. Prior to the adjuster arriving, Nationwide sent out a water midigation crew to remove the affected drywall, insullation, and carpet padding – leaving the dehumidifier and fan to dry the structure and carpet.
    Since the carpet had furniture stains and was delaminated, the insurance is paying for replacing the carpet (original to the house, approx. 10 years old). Since the carpet is continuous, they are paying to replace the carpeting in the dining room, living room, hallway, stairs, and upstairs hall (excluding bedrooms) – this I understand.
    However, the adjuster is only allowing for replacement of the carpet padding for about half of the dining room area – not for the entire area of carpet to be replaced. I have never heard of replacing carpeting without all new padding underneath, and as I understand it – it would void any warranty on the carpet install if I did not replace the padding. In addition, “repairing” the padding in the dining room would likely not look correct – new padding in half of the room with the old compressed padding seamed next to it would be awful.
    Is this a normal policy — to not replace all of the padding for the same area the insurance is replacing the carpetting? When asked, the adjuster told me it would be up to me to ‘upgrade’ the rest fo the padding. I don’t feel this is an upgrade.. Heck, my mother is an insurance adjuster for a different company and has never heard of this either..

  1383. December 5th, 2012 at 9:29 am #Jason

    Jennifer,
    Technically what they are doing is correct based on the coverage language in the policy. This is not a practice done by most insurance companies and this is likely the practice of the adjuster who may be an independent adjuster.

    In this situation, you should state your objection to the insurance company until they concede to replace all of the padding for the reasons you mentioned. New carpeting should have new padding as a general rule in order to do it correctly.

  1384. December 11th, 2012 at 6:30 am #David

    I have mobile home insurance from Foremost Insurance,my home is in a mobile home park where I pay a monthly lot fee.The septic system is owned and maintained by the park I pay rent to.About 5 weeks ago they were getting ready to remove old and install brand new septic systems because the old systems were over 30 yrs old and not properly maintained…I have had alot of septic problems in the last 3yrs.So a couple days before they broke ground my 2 toilets overflowed at the same time for about 10 minutes soaking a large portion of the carpets with brown sewage waste water.The next day the bathtub and dish water did the same and damaged more of my floors.Will they pay my claim to replace my floors?…Ive never made a claim before so i dont know what to do…HELP

  1385. December 11th, 2012 at 6:49 am #Jason

    David,
    Your standard insurance policy will not cover an event you described unless you have added an additional coverage to your policy by endorsement. That coverage is called Water Backup and Sump Pump Overflow.

    Without that specific endorsement, your policy excludes the occurrence(s) you had. You can review your policy, or you can call your agent, to find out if you have that specific coverage.

  1386. December 21st, 2012 at 6:32 pm #fDIYer

    First I am a little hesitant to ask because of all the sarcasm but I am going to put my big girl pants on and hope you will be kind. Second I did scan and read at least 85% of your blog. I did find similar scenarios but not all the answers I was looking for so please forgive if you feel your repeating yourself.
    Short story > Water damage, home insurance appraisal done, claim submitted, all cosmetic, no structure damage, received check for 15K. Found out since it’s over 10K the mortgage lender holds the check releasing 1/3 at a time (I understand the process and why). Additionally, this is my first home, my first insurance claim, and loan is up to date.
    My concern is, originally I had planned on doing most of the work myself because
    A. That is just the type of person I am –DIYer
    B. I feel some things aren’t necessary even though it is included. For example, I just repainted all my walls before the water damage but according to the appraiser if one wall has to be painted then insurance pays to repaint all the walls. Which btw do I have to spend all the paint money on paint if it isn’t necessary or you can’t even tell?
    C. A lot of the labor really isn’t necessary like paying someone to pack a box, prep for painting, or move and reset a piece of furniture
    Most people would say who cares if the insurance is paying for it but for me I’d rather just get done what needs to get done. Having a bunch of contractors in my home and having to take off work is just not something I look forward to. I will if I absolutely have to but hopefully you will tell me I am overthinking this. My biggest fear is the mortgage lender not releasing all the funds and applying the remainder to my loan which according to others online has been done. I also fear I will spend my free time doing the work but not compensated for my time. If that is truly how it all really works I’ll make sure I contract out or spend every dime.
    Now my questions and I’ll try to make it so the answering won’t take a lot of your time.
    1. Does the lender mainly monitor repairs to ensure the value of the home isn’t depreciated or is everything really scrutinized down to the T? For example they match everything on the adjuster claim to the work done. Receipt for boxes cost $50 – Adjuster has $75, Receipt for flooring $2400- Adjuster has $4000.
    2. Can I do partial, any, or all the work myself? From what I have read so far it seems I can. Are there precautions or things I should do to prevent issues this like keep a log or get a few appraisals from contractors?
    3. If you answered YES above SKIP to 4
    Is it required I hire a licensed contractor?

    4. Do I have to paint or replace everything exactly as it was? IE a particular kind of trim work or are they really just looking to see if I spent the money on trim? Actually in some areas I’d rather not replace its just that rule, damage is on one they are all redone.
    5. Does the same insurance appraiser generally come back out to re-inspect for the 40% and 100% inspection or were they done once they cut the check and further inspections will be appointed by the lender? I am wondering how do they really know if something was really done or not? Or do they go off pictures and the report?
    I could go on and on but I am sure you catch my drift. Sorry if it isn’t related to the blog or your realm of expertise. I am not looking for the “law” but rather some guidance. Whatever information you or anyone can provide is MUCH appreciated. And if nothing, that’s okay too. Just don’t beat me up  I really took a lot of time constructing this post and ensuring I verbalized everything correctly.

  1387. December 21st, 2012 at 7:03 pm #Jason

    fDIYer,
    Generally the bank just wants to make sure the damage is repaired. It doesn’t matter the cost, just as long as it gets repaired. You can do the allowed work on your home as a homeowner without having to hire a contractor. However, in many counties, plumbing is not allowed to be done by a homeowner as an example. Another example is that some places do not allow the electrical to be done by a homeowner.

    Also, each mortgage holder is different so the best course of action for you is to communicate with your mortgage holder about what they require for documentation.

    Regarding #5, generally the contractor that does that work reports the percentage of completion as it gets done. But on some occasions the adjuster is sent back out. It’s mostly that the contractor does the reporting of the percentage of completion though. If you do the work yourself, which you can, you have to find out how to provide that percentage completion to the insurance company and/or your mortgage holder. You might be able to verify the percentage of completion with photos and and affidavit that it’s completed, but that will be up to your mortgage holder.

    Just ask if you have any other concerns.

  1388. December 22nd, 2012 at 6:12 am #fDIYer

    Thanks for your quick response!! There isn’t any electrical or plumbing. Plumbing was already fixed by my home warranty company. The damage is only a few walls which the water restoration company already removed and a few lower cabinets. I can repair and paint all the walls no problem. I guess I am concerned because the adjuster has on the draft upper and lower cabinets which yes the lower cabinets were damaged but the top were not, according to him though if one gets replaced they all get replaced. I know remodeling a kitchen can run pretty high so if I can just replace the lower and re-stain everything to match I would rather do that but I am afraid they will be looking for receipts for new upper and lower cabinets. I am also afraid if I don’t spend as much on materials as what the adjuster has on the draft then the repairs will not be considered done. I know I can get everything done under 15K especially doing the work myself which I want to do because the draft does have some ceramic tile replacement (not all) and I know I won’t be able to find matching tile (tried before), also with the removal of the lower cabinets, new cabinets may not match up to the exact flooring. So most likely I will have to redo all the floors which were not included. Should I dispute draft to have it included? According to the draft though it says once check is cashed I cannot rescind the settlement and I have already sent the check to the mortgage lender. But how would anyone know beforehand the replacement tile couldn’t be found. I understand reaching out to the mortgage lender is probably the best method I guess I am weary because of things I have read on the internet. Would it be considered inappropriate if I asked the adjuster who came out for the inspection about any of these questions? Thanks again for your help. As you said in one of your post knowledge is power and I like to be armed with it!! Enjoy your holidays

  1389. December 22nd, 2012 at 6:46 am #Jason

    fDIYer,
    If you want to dispute something that isn’t included in the claim, you can do that. If you can make a good case why something should be included that is not, the adjuster may just add it to your claim.

    You can ask your adjuster questions. They are your direct link between you and the insurance company when dealing with a claim.

  1390. December 22nd, 2012 at 7:25 am #fDIYer

    Thank you!!! Just got off the phone with the water restoration guy too and he was helpful. Enjoy your holidays

  1391. December 29th, 2012 at 2:35 pm #Marc

    My Barn collapsed 2 winters ago from snow. I have a 37 year old disabled son and received a permit to build him a house in place of the insured barn. Can I use the insurance money (Allstate) to build a house instead of a barn

    ?

  1392. December 29th, 2012 at 4:45 pm #Jason

    Marc,
    That is probably a question you should ask of your insurance company adjuster.

  1393. January 15th, 2013 at 8:59 am #Jason

    Tony,
    Your post is very difficult to follow. If you have questions concerning insurance, please take your time and re-post.

  1394. January 19th, 2013 at 12:25 pm #santa

    Hello,
    We noticed some water damage to our laminate wood flooring just outside our bathroom and leading into the adjacent bedroom. We called in a claim for water damage, unsure of the cause. After doing a leak detection, it seems there are no leaks…and the only other think we can think of is that the toilet had overflowed not to long ago and although we had cleaned the mess in the bathroom without any noticable damage at that time, it must’ve gotten under the laminate wood flooring (which starts after the bathroom door) and caused the damage? My question is, do you know how long after a toilet overflows can you still claim the damage caused from it? Thank you!

  1395. January 19th, 2013 at 12:45 pm #santa

    Also, forgot to mention, that the wall in the adjacent room behind the bathroom felt soft so my husband cut out a portion of the drywall to find water damage and mold behind it as well…another part of the repairs. We know that the ins co will not cover the mold, but wanted to include that info to give you the whole picture…Thanks.

  1396. January 19th, 2013 at 12:50 pm #Jason

    santa,
    Generally the time frame allowed to make a claim is 1 year from the date of loss. This can be found in your policy under the topic of “Loss Payment” and/or “Suit Against Us”.

    The insurance policy is a contract between the insurance company and the insured. And the time allowed to bring a claim should fit within the parameters of the contract and when 1 year expires, the legal binding of the contract has expired. That’s why it clearly says, “Suit Against Us” – meaning the terms of the contract do not apply to an event over 1 year old.

  1397. January 19th, 2013 at 1:36 pm #santa

    Thank you Jason for the quick response and for providing this help 🙂

    One additional question. I am not even sure if they will cover us if it was due to the toilet overflow, but do you know if there would be any repercussions for us to tell them that we now think that was the reason for the damages? (Since no leaks were found). I never mentioned it when we originally put in the claim…The overflow was probably a few weeks ago…

    Also I looked up the “Suit Against us” section of our policy and read it…but it does not say anything about the 1 year time frame; is that the standard even if it is not written out that way in our policy?

  1398. January 19th, 2013 at 2:03 pm #Jason

    santa,
    I apologize. I pulled up and reviewed a standard policy that has a stated 2 year period as a time period for the effective legal duration of the policy. That is copied below. This time limitation may differ depending on your state.

    8. Suit Against Us — No suit may be brought against “us” unless all of the “terms” that apply to the Property Coverages have been complied with and the suit is brought within two years after the loss.

    You can contact the insurance company and provide them your assessment that water damage is from when the toilet overflowed. Since you dried it, you did not notice damage from that event and you think that could be the source of the water that damaged your flooring.

    Could there be repercussions? Probably not because you didn’t believe the toilet water overflow was related but you have since pieced it together.

  1399. January 19th, 2013 at 2:23 pm #santa

    Ok, thanks again 🙂

  1400. January 21st, 2013 at 6:10 am #jscott

    I have a claim with Zurich its a builders risk policy I purchase my home at a online aution it caught fire and the insurance company did a estimate to repair the damages I have a copy of it and the price was $45000 in damages to my house I thought they would pay me that to repair my home but they then sent out an appraiser and he did three comps in the area. They came in at $2000, $3000, and $29000. They came in with $2,400 for my home. I want to repair my home, so how do I get them to pay me to repair my home I brought it to move in.

  1401. January 21st, 2013 at 8:36 am #Jason

    jscott,
    The figures you provided in your post range from $2000 to $45,000. That is kind of confusing. Also, when you are talking about “comps”, do you mean “comparables”? If so, why do those range from $2000 to $29,000? In which state did this fire occur? What are the limits of coverage? What is the policy form number in the policy? When did you close on the house and when did the fire occur?

  1402. January 21st, 2013 at 11:07 am #jscott

    I have the apprassial that my adjuster sent me in a email the comparable ranges is $2000-$29000 I think it because of the forclosere in MI. for the three home in the area I am in Mt.Morris twp, Mi Flint,MI 48505 the Policy Type: One-Shot (non-reporting form/single structure policy). I closed on the house on 11/18/2011 and the fire occured 8/23/2012 I told the underwriter that I need $38000 to cover the house and $8000 for renovations the house was in fair condition the outside has new siding and windows and doors I was in the process of repairing the kitchen and bathroom and painting the entire home I brought all used Items from resale shop and I didnt keep the receipts. someone went in the house and stole all the things I repaired back out of there so I was saving more money to go and move in there while I repaired it but it caught fire they never said what cause the fire but they said I was cover I like the area I just want to fix it back and move in there.

  1403. January 21st, 2013 at 3:47 pm #Jason

    jscott,
    I don’t know all the details of the one-shot builders risk policy but from the information you are providing, the home appears to be a total loss because of fire.

    It is likely the insurance company is determining that they want to settle the loss by paying you the ACV of the entire building, and not providing the option to repair because the level of repairs/improvements were minimal.
    Totaling the house at ACV makes more sense to settlement than paying you to restore it to the condition it was before the fire.

    If I understand you correctly, all the improvements you did in the home were removed by theft and then after that happened, there was a total loss fire.

    Your initial question is how do you get Zurich to rebuild your house instead of paying you for its ACV? I don’t know if this is an option because builders risk policies insure a property starting at $0 and it go up the total amount of your insured value on a sliding scale – as the improvements take place. Since your improvement classification was basically at reset to zero because of the theft of all your improvements, the policy threshold is very low at that time of the fire. The value of the policy would be at the infancy stage and not valued very much.

    If you can buy a comparable home for $2,400 and all your improvements were removed by theft, it seems if they paid you $2,400 (including whatever they paid you for your theft), that would get you back to your original position. It is very unlikely the insurance would want to pay to repair the place for tens of thousands of dollars when they can pay you the ACV of the property.

  1404. January 21st, 2013 at 5:01 pm #jscott

    I have $35000 worth of coverage for the house and $8000 for improvements on the policy. I did a zestimate of the addresses that were used for there comparisons and the lowest was $26000 and the highest was $29000 and this was the exact homes that the appraisser they used for the price comparibles.

  1405. January 21st, 2013 at 5:15 pm #Jason

    jscott,
    I don’t know what information you are looking for. The purpose of this site is not to establish, or confirm, values for properties.

  1406. January 21st, 2013 at 5:21 pm #Jason

    jscott,
    Michigan is not a valued policy state. The amount paid by an insurance company for a loss is the lessor of the cost of repair or the ACV. It seems the insurance company is selecting the ACV.

    The accuracy of Zillow valuations is not known so I don’t know how much reliability can be put into that knowing the high foreclosure rate in Michigan.

    We don’t know the amount you paid for this property but that is the best indicator of its ACV. The policy limit doesn’t mean anything in a state that doesn’t have valued policy laws enacted.

  1407. January 21st, 2013 at 8:58 pm #Aj

    My house got burnt down and i was weighing on the option of rebuild or sell as is. If i intend to sell the way it is for cash, do I get any money back from the insurance company such as building and content? I still have the mortgage on it and i would like to pay that off and move on.

  1408. January 22nd, 2013 at 3:11 pm #Tasha Houston

    the insurance company met life paid the claim to BAC to pay the loan off they send us a letter saying it was not enough so this happened in Nov 2012 so now they tell us the home is in foreclosure and they will not use the funds to bring the loan current or pay the home off so what does this mean or what can be done they just decided to put the loan in foreclosure on Jan 15 but has appraised the home already and found out the home is not worth what is owed on it so they denied the the work out to pay the loan off more than likely to foreclose on the home and still keep the money so can we file bankruptcy to keep the home or what

  1409. January 22nd, 2013 at 3:36 pm #Jason

    Tasha,
    Is your question about banking issues or insurance issues? Your comment can be addressed if you provide some concise information and post a question.

  1410. January 22nd, 2013 at 8:07 pm #Aj

    Oh, we live in Texas and our insurance is Farmers Insurance

  1411. January 22nd, 2013 at 8:46 pm #Jason

    AJ,
    Your question could best be presented to your claim adjuster and ask what options you have available.

    Since you live in a valued policy state, if the house is totaled, you should be given the face value of your policy for the dwelling if you were the occupied owner of it. This law generally benefits the insured in cases such as yours if all the parameters are met.

    The personal property doesn’t work the same under the valued policy laws and that is best to be discussed with your adjuster. At minimum, you should be paid the ACV of your personal property and the option to get those items paid at full replacement cost if you purchase the items within the time frame outlined in the policy. Personal property is not specific as to what you do or don’t do with your current property.

  1412. January 26th, 2013 at 6:56 am #Steve

    I had damage to my property due to Hurricane Sandy. Allstate sent me a check minus my deductible for the damages on my home owners policy. I have not heard anything more from Allstate since. My question is does Allstate send a 1099 to the IRS that I have to be concerned about? They have not asked me to fill out 1099 info and so far I have not gotten anything in the mail that says they sent one to the IRS.

  1413. January 26th, 2013 at 7:55 am #Jason

    Steve,
    Insurance payments are not 1099 income and you won’t receive a 1099 tax form for the payment you received.

  1414. January 27th, 2013 at 9:34 am #Emmy

    Our ins company paid for repair/rebuild of our wood fireplace and chimney after a chimney fire. However, since the contractor finished the job, we have been unable to use the fireplace as smoke pours into the room. He is now suggesting we install a very expensive chimney fan which we would prefer not to do.
    Do I go back to the insurance company and ask that they cover either this additional cost, which we don’t really want and don’t know if it will even solve the problem or ask if they’d cover having another contractor look at fixing this? Would they want the money back from the original guy?

  1415. January 27th, 2013 at 9:48 am #Jason

    Emmy,
    The insurance company did what they were supposed to do and that is pay for the repair/rebuild of your fireplace and chimney. If it wasn’t done correctly, then that falls on the contractor you hired to do the repair/rebuild.

    The insurance company isn’t going to cover the cost of another contractor to fix the work of the original contractor. The insurance company is not going to want the money back for the original contractor since that was the determined cost to repair/rebuild your fireplace and chimney and is a legitimate expense that they paid.

  1416. January 27th, 2013 at 3:26 pm #Moderator1

    Emmy,

    Have you looked to see if the fireplace chimney damper is open?

  1417. January 30th, 2013 at 8:48 am #Vickie

    My husband fell off a roof and broke his back, while installing a satelite dish. The hospital is telling us to file a claim with the owners homeowners insurance. Will the persons home owners insurance cover anything?

  1418. January 30th, 2013 at 10:18 am #Jason

    Vickie,
    If the other person had home insurance, there may be a small amount (usually between $1000 – $5000) available as medical coverage for anyone that becomes injured on that home owner’s property without regard to negligence of the home owner.

    If the home owner was negligent for the injury by means of doing something that caused the injury, or failing to do something, that a reasonable home owner should have done (or not done) to prevent the injury, then there may be liability insurance for any negligence that may exist.

  1419. January 31st, 2013 at 3:15 pm #Plumber caused leak

    Hi I have a plumber who instaled a instant hot water dispenser undermounted under out kitchen sink. That night we noticed that the kitchen and dining room were flooded with water and water was pouring out throught the kitchen door into the garage. This caused serious damage to our hardwood floors which are now warped and uneven.

    The plumber came by to fix the leaking and told us he failed to properly tighten something which was what resulted in the leak. The plumbers insruance agency has just contacted us to ask about the issue.

    Is there anything I should be aware of when I speak to them? There seems to be no other alternative to fix the floors other than to replace the entire downstairs hardwood flooring because the wood that we used goes throughout the entire downstairs area (about 800 sq ft). The size of wood we would need to replace is no longer available so we need to go with 4 inch pieces rather than the 3 inch pieces we have now. The plumber suggest that he only change the kitchen area with the 4 inch pieces but we can’t have 4 inch pieces in the kitchen then 3 inch pieces in the living room and dining room. The whole point is to keep the consistency and feel of the downstairs area and having different sized flooring won’t work.

    I have a feeling the insurance agency will only agree to change out the kitchen flooring so how can I argue that they need to change all of the flooring to give us the “same/like” flooring design and look that we had before the plumber flooded the area. Why should we have to now have mix matched floors. over half of the flooring was damaged so shouldnt there be a threshold number where thye say “total loss” and therefore “Total replacement”?

    Any advice is really appreciated. I hesitate to contact my own insurance agency because I don’t know if they will be able to help or would even offer any advice. Just don’t trust any insurance agencies.

  1420. January 31st, 2013 at 3:55 pm #Jason

    Plumber,
    If the plumbers insurance company accepts liability for this damage, then, the plumber’s insurance company’s obligation for this damage is to pay you the ACV. That would mean the replacement cost, less depreciation.

    Your personal homeowner’s policy very likely has a replacement policy provision that will cover the full cost of the replacement, without regard to depreciation when it’s all said and done.

    The recommendations with the plumber’s insurance company is to take a position and hold it until they give in. They want the claim closed as much as you want your home back to its original condition.

    My strongest suggestion is to file this with your homeowners insurance. Sure, you will have to incur your deductible but you should get that back after your insurance company collects it from the plumber’s insurance company.

  1421. January 31st, 2013 at 9:30 pm #Plumber caused leak

    Thank you for your response Jason. This helps put me at ease.
    So do I contact my insurance agency and tell them what happened and then provide them with my plumbers insurance agents information and let them hash it out? We truly just want our floors back to the original condition but want to be sure we don’t get stuck with a 2K deductable.

    Would this mean I have to find a contractor to give me a quote on how much it would cost to replace the floors or will my state farm insurance and my plumbers insurance send two separate claims adjustors to assess the situation? Then what? I wait and let the two insurance companies negotiate or do I do that?

  1422. February 1st, 2013 at 8:50 am #Jason

    Plumber,
    One of your options would be to contact your agent and provide the information to initiate a claim with them.

    Yes, no matter what, you are going to have to find a contractor to do the work. Neither insurance company will do that for you. They will come up with an estimate but not a bid from an actual contractor.

    Each insurance company will send their own adjuster to determine the amount of damage and to prepare an estimate of repair.

    Like I said before, demand what is reasonable from the plumber’s insurance company and don’t just take any offer they propose. Stand firm and know that you can go through your own insurance company if you can’t get an acceptable settlement from the plumber’s insurance company.

    Even talk to your insurance company to find out how you will get your deductible back since that will be a factor for you until it is collected from the other company’s insurance company.

  1423. February 1st, 2013 at 11:17 am #Plumber caused leak

    Hi Jaon, will our premiums go up if we file a claim with our own insurance agency/State Farm.

  1424. February 4th, 2013 at 5:19 pm #Jason

    Plumber,
    Your rates should not go up. However, if they do, it should only be a modest increase. This is not considered a claim that resulted from something you did, but something the plumber did. Your insurance should be able to collect all that that they can legally recover from the plumber’s insurance so they are merely processing a claim for you as the middle-man between you and the plumber’s insurance company.

  1425. February 5th, 2013 at 7:42 am #Cindy

    We were just informed by our agent that we had a home inspection done a month or so ago and have areas of serious concern.
    We’ve had the policy in place for 20 years and have only had 2 claims 15 years ago for lightning strikes and they were not substantial losses.
    My question is why would we have a home inspection done. Not be notified that we were having a home inspection.
    Our policy isn’t renewing for another 7 months.
    We have requested a copy of the inspection and are still waiting to find out what the problems are.
    Our home is in excellent condition with no known issues. Husband is a builder and is meticulous about keeping our house looking great.

  1426. February 5th, 2013 at 8:12 am #Jason

    Cindy,
    All your questions should be able to be answered by your insurance company since your questions focus on that recent inspection.

    The insurance company very likely will not forward you a copy of the inspection report, even if you asked for a copy.

  1427. February 5th, 2013 at 8:43 am #Cindy

    Is it normal to have an un-announced home inspection?
    I have children who stay home alone occasionally and would be scared to have someone snooping around the house. Just not feeling like this is appropriate behavior for an inspection these days. We had recently had break-ins and my children would have called 911 if someone was snooping around while they were home alone.

  1428. February 5th, 2013 at 8:46 am #Cindy

    The break-ins were in our community. Not our neighborhood. Friends children were home alone when 2 men were peeking in their windows and then claimed to be there to pick up furniture (and they were in a small car).
    I think for everyone’s safety it is appropriate and necessary to be notified when someone is coming to your home.

  1429. February 5th, 2013 at 2:42 pm #Jason

    Cindy,
    I am not aware of anything that would make a home inspection illegal. An insurance policy is a contract involving 2 parties. Just like you have the opportunity to check the financial standing, rating, and other aspects of an insurance company before, and during the entire time you are insured with that company, the insurance company has the right to inspect the properties they insure.

    Many commercial policy Conditions contain this language:

    Inspections and Surveys
    1. We have the right to:
    a. make inspections or surveys at any time

    Typical homeowner policies contain this language:

    6. Inspections — “We” have the right, but are not obligated, to inspect “your” property and operations. This inspection may be made by “us” or may be made on “our” behalf.

    (Neither of these policy Conditions spell out whether or not a notice needs to be given prior to an inspection.)

    Inspections that do not notify you of the time of the inspection may be rude but it would appear the insurance company can inspect your property because of the policy language.

  1430. February 6th, 2013 at 8:24 am #Jim

    I asked my bank if a windstorm policy was required for my home since citizens intended to double my rate and cut coverage in half. I recieved in writing that i was NOT required to have windstrom coverage. I have just recieved a letter from the bank stating that I am required to have that coverage and they were purchasing a policy at a rediculous rate, and it would be prorated to the date that the last coverage expired. I am grudgingly willing to obtain a policy but do not feel that its fair (or legal) to prorate the policy since I allowed it to lapse based upon their statement. Do I have any rights or recourse in this matter?

  1431. February 6th, 2013 at 8:34 am #Jason

    Jim,
    Your question is about banking not about insurance.

    The thing is that when your rates go up and/or coverage goes down, switch to another insurance company. There are hundreds and hundreds of insurance companies that provide coverage.

    As for the coverage, find an agent and explain your situation to him. Inform him there have been no losses and you are looking for coverage effective from a certain date and let him know that you will pay him the premium immediately if he can help you. If you find an agent willing to do this, that might be your best route.

  1432. February 10th, 2013 at 12:26 pm #julie

    hello, i have insurance with AAA of southern california with guaranteed replacement. about 3 months ago i had water damage causing damage to the walls in one bathroom and the removal of the floorings in two bedrooms and part of the hallway. the house was built in the mid-50s and i bought it about 10 years ago. the last owner had put carpet over the original parquet, and i had been hoping at some point to remove the carpet and restore the original parquet underneath.

    after the environmental testing, AAA assigned a contractor who did the demo, but that contractor abandoned the project after about 3 weeks. i interviewed two other AAA contractors and chose one who wrote up a a new repairs estimate. the new contractor was very thorough and sent a parquet square to ITEL to see if it could be matched. about a week later, i was told it couldn’t be matched nor custom milled.

    AAA is willing to replace the carpet in water damaged area and thru the continuous area (thru the living and dining room areas) but has said that since the original 9×9 parquet squares are unavailable and can’t be matched, a different wood flooring will be installed in just the areas where there was water damage. this means that long narrow planks will meet the parquet squares in the middle of the hallway. i asked the adjustor about the guaranteed replacement and he said that once the parquet was covered it became “dead” as an underlayment and that AAA was going above and beyond, and i was fortunate they just didn’t put down plywood.

    still wanting clarification, i emailed the adjuster asking for a copy of my policy (i had lost mine) regarding flooring replacement (multiple floor coverings, doorway/continuous area, etc.) and a written explanation on the replacement for the damaged parquet. i received a letter explaining that AAA is not obligated to repair continuous underlayment and that coverage didn’t apply to this portion of my loss. i am still waiting on a copy of my policy to arrive. however i called my agent who confirmed that i had guaranteed replacement.

    is what the adjustor said true and that if the parquet can’t be matched, they don’t have to match wood flooring in the continuous area? this doesn’t come under “made whole”?

    it is approaching 3 months without repairs beginning and i’ve lost a re-fi application because of it. i would like this resolved quickly and repairs started soon. while i don’t want to ask for something not covered in my policy, i’d like to be sure it’s not covered in my policy.

    do i go to the next level and ask the adjuster’s mgr to look into this…or do i bite the bullet and pay retail to continue the planks to the end of the hallway (i can’t afford thru the continuous area.)

    btw i asked the AAA adjuster not to send the two-party check to the new AAA contractor until i saw the repair estimate that AAA approved. instead, the adjustor sent me a three-party check with my 1st and 2nd mortgage lenders on it (even tho’ i had told him i didn’t want to “cash out”.) when i called him on the phone, he said when i decided to go with the new AAA contractor, he’d issue a new check, but that means i’m accepting their decision on the parquet…which i’m hoping is resolved very soon.

    one last question — is it usually better to go with an AAA contractor than to cash out and hire an independent contractor…and why?

    sorry for the length and thank you for the information!

    🙂 julie

  1433. February 10th, 2013 at 12:41 pm #Jason

    julie,
    Your parquet is a sub-flooring and is considered nothing other than that when another flooring material is on top of it. It also doesn’t matter what your future plans were to restore that flooring by removing the carpeting. The adjuster is correct in the information provided.

    It’s your choice to select whatever contractor you want to make the repairs. The why is that you are the homeowner and you decide which contractor you want.

  1434. February 10th, 2013 at 12:46 pm #julie

    thank you!

    so if i had removed the carpet prior to the water damage, then the coverage would’ve been for the wood flooring throughout the continuous area?

    the coverage also indicates i have “green coverage”. i’m concerned about off-gassing of VOCs from new carpet. does green coverage mean i can ask for green carpet?

    thanks again,

    🙂 julie

  1435. February 10th, 2013 at 12:58 pm #Jason

    julie,
    If you had parquet flooring, the answers provided would be different than the answers about carpeting as the top flooring surface.

    I don’t know what green coverage means. The term green relating to rebuilding generally means it’s fully or partially recycled material.

  1436. February 10th, 2013 at 1:12 pm #julie

    i see…thank you for the info. much appreciated 🙂 julie

  1437. February 19th, 2013 at 2:50 pm #Can I be denied insurance coverage??

    Long story short I am trying to find out if what Allstate did to me is legal. I have had allstate for my homeowners insurance for all but 3 years. Made a wind and hail damage claim last year because my roof was damaged they jacked up my rates almost $250 for the year. So I went with another plan that allstate offered and got it at a reasonable price. Now my policy went into effect nov 20th 2012 and I got a letter from them jan 19th saying that they came out to my house and said that my attached garage which is still being built ( building permit is displayed in the window ) they said it did not have the appropiate exterior coating on it so they are dropping me for homeowners insurance coverage. Now my garage is attached and 3/4’s of the exterior is done and sided the rest of it will be brick so that it matches my house. The garage isn’t completely exposed it has 5/8’s exterior plywood with standard Tyvek House wrap over that. My question is can they cancel me because of that?! And also they came out and onto my property which has no trespassing signs shown and walked around my property ( I have video surveliance of this) Can I press charges for that? and now they have sent me a bill stating I owe them some money for the X amount of days of coverage that they “provided” and I refuse to pay. Any suggestions on what to do?

  1438. February 19th, 2013 at 3:38 pm #Jason

    Can I be,
    If you look at the Best and Worst Insurance Companies rating at the top of this page, you will find Allstate as one of the leading worst insurance companies.

    This may be the time to find a better rated insurance company, and probably lower insurance rates as well.

    Your insurance company based on the insurance contract can cancel for any reason based on this standard policy language:

    C. Cancellation
    2. We may cancel this policy only for the reasons stated below by letting you know in writing of the date cancellation takes effect.
    b. When this policy has been in effect for less than 60 days and is not a renewal with us, we may cancel for any reason by letting you know at least 10 days before the date cancellation takes effect.

    With your garage is being constructed, the insurance company probably doesn’t want to have the risk associated with property that is under construction. They can basically cancel your coverage by providing you with sufficient notice.

    Trespassing is not an insurance issue. It is likely the insurance company hired an inspection company to look at your property. If you wanted to get the inspection company in trouble, you could pursue that but if they didn’t do any damage, it will be a tough time to have law enforcement do anything. And it will not involve the insurance company because they don’t control the activities of their independent contractors.

  1439. February 20th, 2013 at 10:56 pm #Jerry Davis

    My rubber hose to my washer busted & when I got home from work I had 4″ of water in my entire home, all 1700 square feet. Servpro had to remove the dry wall flooring & carpet throughout my house. It took them 108 hours to get all the water out. I’ve been in a hotel for 7 days now. I met the insurance adjuster for the first time today, 02/20/13. The adjuster told me that I need to move back in my home because its habitable, even though the dry wall has been cut out above the plug outlets & there’s bare wiring exposed & there’s no flooring or carpet and there’s nails sticking up from the concrete from the tack strips. I have two grandchildren that live with me that are two & three years old. Just concerned for their safety due to the electrical being exposed. Is this habitable? Can the insurance company do this?

  1440. February 21st, 2013 at 6:30 am #Jason

    Jerry,
    Yes, it’s habitable. The wires in the walls may be observed but just because you can see it doesn’t mean anybody is going to get a shock. The most dangerous area are the electrical boxes because that is where the electricity is live.

    A good remedy for those tack strip tacks is to put 1 or 2 layers of duct tape over it.

  1441. February 21st, 2013 at 10:59 am #Doug

    Insurance adjuster accessed the damage to roof and agreed upon complete replacement………Check from insurance will have our names ( me and the wife plus mortgage company. ) Will we need to lay out the money for the repairs prior to receiving the insurance check back from the mortgage holder. Also will any contractor work on good faith and understanding with proof that insurance check will be coming to me after completion of job for payment……Thank you ………

  1442. February 21st, 2013 at 6:55 pm #Jason

    Doug,
    There should be contractors around you that deal with insurance companies, homeowners, and mortgage holders all the time. You will just have to make arrangements with your contractor about what is acceptable as far as payments to him. Contractors may want a down payment but that differs with each contractor. Just ask the contractor about what is acceptable to him.

  1443. February 22nd, 2013 at 3:08 am #Doug

    Thank you once again……..BTW ….I didn’t get the actual figure of what the insurance company is paying us for the new roof yet……adjuster said you are entitled to a new roof and full replacement and will be paid for that. Say I go ahead, lay out the money ahead of time ….replace the roof with a contractor and the payment from the insurance company is either lower or higher than what I paid….What will happen in both scenarios………Thank you and appreciate the info.

  1444. February 22nd, 2013 at 8:37 am #Jason

    Doug,
    Because you know the information about your roof being covered for replacement, you should also know the expected ACV damage, and the replacement value, of the roof damage. The insurance company already knows this and if they know it, you should too. It’s your roof.

    Now, slow down with this claim. The contractual relationship you have with your insurance company does not involve the contractor. You can let your contractor know the roof is covered by insurance but he doesn’t need to know any of the numbers. Would you tell your buying customers what you pay for your product and how much you mark it up? The contractor is actually your customer. The contractor is buying your money in trade for a replaced roof.

    The relationship between you and the contractor does not involve the insurance company. Your insurance company doesn’t need to know how much your contractor is going to charge for the roof replacement. The insurance company should already know what the costs are going to be based on the information they received from the adjuster.

    Let’s say the cost to re-do your roof at replacement cost is $5000. If the contractor charges you between $4000 and $5000, then that is a decent proposition. Does the insurance company have to know? No.

    However, if your contractor wants to charge you $6000, then you will need to let your insurance company know about this so your insurance company can adjust the replacement cost for your roof to $6000 and so they allow that amount for your claim.

  1445. February 27th, 2013 at 6:44 pm #linda muench

    my foundation collapsed during hurrican sandy. my flood insurance did not include the price to fix the foundation in the claim. when i called them i was told the foundation collapse was due to crumbling. twenty feet of my wall fell in with two giant slabs not little crumbles. they rest of the walls are in good shape except for a few minor cracks due to the amount and pressure of the water. i really need them to pay for the repair of the foundation. i am two hundred feet from the beach so i took a direct hit. the house bounced off the foundation and this is evident by the crack all around the chimney and the branches stuck between the foundation and house. can i fight them on this and should i get a lawyer.
    thank you for your help at my wits end

  1446. February 27th, 2013 at 6:57 pm #jen

    hey i live in tn and have farm bureau ins my question is that our first adjuster told us that as long as our claim was under 5000 we would not have to have our lender on the check well the claim ended up being under 5000 but now we have a new adjuster and he says that he dont care if its under 5000 he is putting the lender on the check. so i called the first adjuster and told her he said that and she said that she doesnt know what he is doing that he has to follow the same guidelines as she does and that the cutoff price for having the lender on the check is under 5000 so my question is can he do that? the reason i dont want the lender on the check is cause they are out of state and really hard to deal with cant even get them to call us back… PLEASE help me

  1447. February 27th, 2013 at 7:33 pm #Jason

    Linda,
    Without knowing the exact language of your flood policy, the coverage for foundations generally provides coverage for abrasive type erosion of foundation-supporting soil that causes damage to the foundation.

    It is imperative to know the coverage of your flood policy so you can converse intelligently with your adjuster and support your claim that the foundation should be a covered part of your claim.

    If you review your policy and talk to the adjuster about the foundation and they still do not cover that part of your claim, obtain their position in writing.

    You have to weigh the costs and benefits associated with getting an attorney. You are the most intimate person relating to your claim and you are the only one that can make that determination. If you decide to hire an attorney, that written position of the insurance company is something your attorney will need to have as a starting point.

  1448. February 27th, 2013 at 7:42 pm #Jason

    jen,
    Your adjuster can add your mortgage holder on the check regardless if it’s under $5000. That will not benefit you.

    And since that action of adding that mortgage holder on the check is going to raise some problems on your end, it’s also going to raise some problems for this new adjuster too.

    Those problems he will face will be you calling his claim manager and explaining that many insurance companies follow the routine policy of not including the mortgage holder on checks under $5000. And you were assured of this by the first adjuster already.

    Let the adjuster know you’ve been informed no mortgage holder was going to be added and you know that from the original adjuster. If he still insists, let him know that you will be addressing your concern with his claim manager. The claim manager should be able to resolve this for you if you don’t get it resolved with the new adjuster first.

  1449. February 27th, 2013 at 8:08 pm #jen

    ok ty so much we asked to speak to his supervisor but he told us that he was out of the office till monday and that it wouldnt do any good to talk to him anyway.. we are going to call him anyway though the new adjuster is very rude anyway hung up on me and my husband. so is there anything we can do mon if we talk to the supervisor and he will not back up what the first adjuster has told us

  1450. February 27th, 2013 at 9:37 pm #Jason

    jen,
    If his supervisor is not in the office, speak to his supervisor’s supervisor. The supervisor should cave in to not include the mortgage holder because these people have a desire to get the claim closed on smaller claims like that. You pay that adjuster’s salary (with your premiums) so don’t let someone that works for you be rude and hangup on you without you reporting that kind of conduct to his manager.

    This adjuster is just asking to be reported to his supervisor. Imagine his performance reviews with all the customer complaints he will have. He shouldn’t be working for a company if he is rude and hangs up. You are the one dealing with a property loss, not him.

  1451. February 28th, 2013 at 6:31 am #Mary Thompson

    Hi–any advice will be appreciated–my house burned down last year due to lightning. We are in the process of rebuilding. They allowed us 2200 per month to rent a house. We moved in to my husband’s rental and the tenant moved out–he was renting it for 2500 per month..We are newly weds both our spouses died and we were lucky enough to have found each other. We are older so we have a prenuptual agreement. His house which is rented is a source of income to him so he has been keeping the 2200 per month. Now the insurance company does not want to give us any more (loss of use) money because we are living in a house we both own– which is not true–it’s David’s house–what do we do? Hire an attorney?

  1452. March 7th, 2013 at 6:58 am #Michael

    I recently had a house fire and my insurance company has agreed to pay Replacement costs for the structure. My contractor may acutally complete the job for less than the amount of the payment provided. I endorsed the original check from the insurance company and forwarded it to the bank, who is subsequently issuing appropriate payments to the contractor.

    What happens to any unused funds that have already been recieved? Does the insurance need to recieve a refund from the mortgage holder? Can I retain the funds for improvements to the house?

    Thanks

  1453. March 11th, 2013 at 12:33 pm #BG

    A pole barn has had a roof collapse from snow. It is covered under the outside dwelling clause of my Homeowners policy. As with likely every person who posts here my frustration level is very high. The property in the barn is where I am having issue. They are trying to deny claim for mowers, old tractors, golf carts, etc. tools, anything that was not normally exposed to weather but was under 3 feet of snow and roofing materials for 10 days. I do not see a definition of what personal property is in the policy. I am not understanding even how a car that was damaged that only had liabilty coverage itself, considering the dwelling collapse caused the damage. Why is that not covered by Homeowners? Collapse is covered in the policy. I use the shop to rebuild old equipment as a hobby. Many automotive parts and motors, transmission or electical components are being denied in the claim as they are automotive in nature. If they are not in a vehicle, how is this not personal property, not part of a vehicle, not being repaired for a vehicle, but rebuilt as part of a hobby. Now that they have been exposed to water, many are damaged beyond repair, or needing complete rebuild again, escpecailly the electrical parts. Golf carts used on the property that are not licensed are also being denied under the claim. They say will replace the equipment used to work on these things. (This is not a business structure.) This seems like selectively applying what is covered and excluded under personal property on premises.

  1454. March 11th, 2013 at 3:32 pm #Jason

    BG,
    Insist that the insurance company pay for the items they are saying are not covered, and if it comes to their insistence to deny those parts that are not a vehicle or on or in a vheicle, it should be covered. (In their attempt to draft a denial for those parts, the insurance company will have a difficult time because the policy only excludes vehicle parts while on or in a vehicle.)

    You can look in your homeowner policy under section C. Personal Property to get a better idea of what is and what is not covered by your policy.

    Part of the standard Personal Property language is below:

    Personal Property Not Covered — “We” do not cover:
    3) “motorized vehicles”.
    a) This includes:
    (1) their parts, equipment, and accessories, other than property described in c.3) above;…
    while in or on a “motorized vehicle”.

    Please note that “motorized vehicles” is defined in your policy.

    Now the c.3. that they refer to is the following:

    c. Limitations On Certain Property — The special “limits” shown below do not increase the Coverage C “limit”. The “limit” for each class is the total “limit” per occurrence for all items in that class.
    3) $1,500 on electronic devices and accessories while in or on a “motorized vehicle” or watercraft, if the device can be operated from the electrical system of the “motorized vehicle” or watercraft and by another source of power. Accessories include antennas, films, tapes, wires, discs, records, or other media that can be used with such devices.

    What the above means is that “motorized vehicles” are excluded from coverage. However, it points out that parts have some limited coverage while ON or IN a motorized vehicle. It seems to apply to electronic components (that are on or in a motorized vehicle).

    From your description, these parts that are damaged are not in or on a motorized vehicle. You have to understand that this claim for the adjuster is confusing and you have to hand-hold them through the entire process.

    Parts of motor vehicles – while in or on the motorized vehicle are excluded except for a few that identified in c.3.

    Now, since we know that the parts were not in or on any vehicle, those parts, based on the policy language, are not excluded items. if those parts are not excluded, then they should be covered by the policy as personal property.

    I hope this helps you understand your coverage. In order to fight for your coverage, you will need to help the adjuster know why you have coverage based on the contract of insurance coverage and you will need to be able to understand the policy language to explain why you have coverage to this adjuster.

    Something really important is your hobby as it relate to these parts. The homeowner policy limits coverage for business personal property so make sure your insurance adjuster knows that those are hobby parts and not business parts.

    If you need additional help, post again.

  1455. March 12th, 2013 at 1:48 pm #Neil

    Does the policy holder have the right to choose his own contractor to do the work on a roof claim even if the ACV check is written to the policy holder and the financier of the property?

  1456. March 12th, 2013 at 1:56 pm #Jason

    Neil,
    The only person that can make decisions concerning their home is the homeowner. So the homeowner is the one that chooses the contractor to do the work on their home and the mortgage holder and insurance company are left out of that decision.

  1457. March 14th, 2013 at 2:06 pm #Karen

    We have had several storms and had roof damage since IKE in 2008. Filed one claim in 2008 for leaking roof, but State Farm said damage was less than deductible so we got it repaired. Three years ago had adjuster come out for another leak in same room and he said that roof did not need to be replaced only to get leak fixed so we did. Now my neighbor is getting her roof replaced. She had roofing company come out because it was leaking from recent storm and was told that her roof needed to be replaced. So Farmers replaced the roof. I’m thinking that I need to get a roofing company come out to check my roof to see if there is damage. What if it needs to be replaced and State Farm doesn’t replace it, what do I do?

  1458. March 14th, 2013 at 3:04 pm #Jason

    Karen,

    Get a roofing company and have them check your roof. Hypothetical questions are difficult to answer.

  1459. April 2nd, 2013 at 5:21 am #Michelle

    I recently lost my engagement ring while out walking. The ring was detailed separately on our household insurance policy.

    We pruchased my enagagement ring in New York and paid less that what the ring has actually been valued at.

    Are we entitled to receive the full valuation amount or will this be restricted to what we actually paid? If we receive what we paid, we will not be put back into the position we were in prior to this unfortunate event unless we travel back to New York of course. Will the cost of travelling be covered if this is the case?

  1460. April 2nd, 2013 at 9:16 am #Jason

    Michelle,
    Your ring will be settled based on it’s value. Many insurance companies have wholesale jewelers (such as Gemcor) that they are contracted with that will provide replacement jewelry at wholesale costs for their insureds.

    With that in mind, your valuation and insured amount of the ring may have been at retail price but if the insurance company can replace your ring through a wholesale jeweler, they will give you the option of replacing the ring through the wholesale jeweler or may offer you the wholesale value. Either way, you will be able to get a replacement ring for the one you lost – at an affordable price since the retail markup on jewelry is very high.

    You have to realize that jeweler’s business locations are not limited to new york. There would be no need to travel because replacement transactions with wholesale jewelers occur using over-night parcel delivery.

  1461. April 4th, 2013 at 10:12 am #jen

    hey i talk to u a couple weeks ago about the insurance putting my lender on the check well they ended up putting the lender on the check anyway. and now my lender says that we cant do the work ourselves that it has to be done by someone with a business license r they wont sign off on the check. so my question is can they tell us that we can do the repairs ourselves? i thought that u could do the repairs if u wanted to , to save money am i right or wrong? thanks so much for the help

  1462. April 4th, 2013 at 10:39 am #Jason

    jen,
    The parameters of what you need to do now are based on the policy of the lender at this point. If they require you to hire a contractor to do the work, then you have to abide by their wishes for the lender to release the money.

    You might want to find out more about your lender’s policies to see if you, as the homeowner, can do some of the work yourself. Some states allow the homeowner to do home repairs and home modifications without the need for a licensed contractor and/or a building permit. That is beyond the scope of this site which responds to insurance questions. The issue you face is based on requirements of your lender.

  1463. April 4th, 2013 at 7:02 pm #Jill

    Please help!

    We had water damage to our home from a pipe. Our adjuster said we would be approved for all new flooring in all of the rooms that were in line of sight. They came out and took a sample of what we had, and it is marble. The tiles can’t be matched to replace the ones that were torn up. Since the amount is large because marble is expensive…NOW they are saying our family room will not be covered because there is a break. The room is a 4 inch step down from the room where the damage ocured. It all has the exact same flooring and it is continuous. They are saying they don’t have to cover that even though putting in new flooring that will butt up against the old will cause a height issue ( safety and liability issue) and will ruin the resale value since there is not other flooring that will look right next to the old.

    I don’t see this rule in my policy anywhere. Can I fight this?

    Also, I am fighting the adjuster to see a copy of how they got their numbers for the value of the floor since it seems very very low. Do I have a legal right to see the breakdown?

    Please help! I need an answer fast. This is in Arizona by the way.

  1464. April 4th, 2013 at 8:06 pm #Jason

    Jill,
    Find a contractor that can do the work and ask him to provide you with an estimate to do the work outlined by your insurance company so you can confirm that an actual contractor can do the work for the figures the insurance company is relying upon.

    You are entitled to see the figures from which the insurance company is basing their offer. So just ask them for a copy of it for your review.

    If there is a 4 inch step separation, that is a justifiable area where the floor should be replaced. You have to understand that marble is a natural occurring product and by the natural formation of marble, one piece will never exactly match another piece. The replacement marble should be fairly easy to obtain in tone, color, and texture to the marble you currently have.

    The policy provides for coverage for direct damage and is silent concerning the concept of “matching”. The courts have in most cases sided with insurance companies on the topic of matching. A physical break, inside corner, outside corner, horizontal/vertical break, and rooms entrances are areas the courts have accepted as reasonable areas for terminating the policy’s responsibility when trying to define what area is covered and what is not.

    The more you complain and fuss about where they stop, (if it’s arbitrary or creates on obvious visual incongruity) the more likely they will cave to your demands. However, if I understand correctly, there is a 4 inch separation and that would meet the requirements of a reasonable area to stop the floor replacement.

    I don’t know to what you refer when you say a liability and safety issue if there is already a 4 inch step. If before the replacement there was a 4 inch step and after the flooring is replaced there is a 4 inch step, that should not even be a concern.

    Marble endures very well as a floor covering and if you have new marble in the room that is affected, the resale value should remain relatively the same, or increase slightly.

  1465. April 9th, 2013 at 7:55 pm #Steve Lauer

    I discovered a bullet hole in the roof of my house. I recovered the bullet from the hole (it went into the shingle to the debth of the buttlet’s length). The bullet is a 45. There is additional damage to several singles from hail and wind over the years.
    I have what is described as T-Lock style shingles and my understanding is that the this shingle style is no longer being made and therefore repairs cannot be made. A new roof is the only solution. My questions are:
    1. Will the insurance company cover the replacement cost for a new roof based on the damage from the bullet?
    2. Will the insurance company cover the replacement cost for a new roof based on the damage from hail, wind, etc?
    3. Will the insurance company cover the replacement cost for a new roof based on the damage from both?

  1466. April 9th, 2013 at 8:15 pm #Jason

    Steve,
    1. A reasonable repair for a bullet hole is not the complete replacement of the entire roof. A reasonable repair would be to fix the bullet hole and nothing more.

    2. and 3. An in-person inspection of your roof is needed in order to make a determination about what needs to be done.

  1467. April 10th, 2013 at 2:52 pm #Steve Lauer

    Jason,
    Thanks for the fast reply. I’ve had a roofer stop by and do a quick once-over. His feeling is that the entire roof should be replaced (I pretty much expected that suggestion; that’s how he makes money). His reasoning was that because these particular shingles aren’t being made anymore, a repair of affected shingles would not match existing. Several roofs in my neighborhood have been totally replaced using this reasoning. All the roofs tended to look just like mine, except for the bullet hole ofcourse. All, including mine, have several scattered spots of hail damage (he pointed those spots out to me. I noticed them some time ago but didn’t realize that they were hail damaged.
    Would it be prudent to have him come back and let him work with the insurance company or should I go strictly by what my insurance adjuster says (I haven’t contacted the insurance company as yet).
    Thanks

  1468. April 12th, 2013 at 7:37 am #jerry

    The back door to my home was kicked in destroying the jam. The insurance company only want to replace the jam. My concern is when I purchased the door it came as a kit door and jam together. Is this normal practice? Thanks

  1469. April 12th, 2013 at 8:49 am #Jason

    jerry,
    When you buy a new car, it comes all together complete with everything needed to drive it including tires, fenders, and windshield. Even though you buy a car fully complete, you can replace parts of the car when they are damaged.

    This same principle applies to doors, jambs, and thresholds.

  1470. April 12th, 2013 at 10:25 am #jerry

    Jason,

    It is the back door to the house not the car.

  1471. April 12th, 2013 at 10:47 am #Jason

    jerry,
    Complete houses are purchased every day, yet when a window, a water pipe, toilet, or a floor tile is broken, the entire house is not replaced, just the broken component.

    Doors are made up of 4 primary components. They include the door slab, jamb, threshold, and lockset. If one of these items is damaged, it does not require the replacement of the remaining undamaged items.

    The automobile example was provided because this concept applies to any item made of individual pieces.

  1472. April 23rd, 2013 at 10:14 am #Dave Groff

    I recently had a tree fall on my house in Dec. I got a few estimates but was not comfortable waiting for a GC to get the roof fixed before something else occurred so I obtained a roofing company to perform the work. I am still working with the GC and State Farm to get the claim settled to start work. State Farm pays a 10% admin price and a 10% overhead price for the GC profits. The State Farm adjuster is now saying he isn’t going to pay the admin and overhead for the roof because I did that myself. Is that normal or should I be getting those funds?

  1473. April 23rd, 2013 at 10:43 am #Jason

    Dave,
    The overhead and profit are estimate lines that are fabricated and demanded by general contractors. It’s like having estimate lines for “blackmail fee”, “under-the-table payment”, or “extortion fee”.

    Since property owners do not have the expense of overhead (and are unable to “profit” due to their personal loss) as a business requirement, it is very unlikely they will allow those fees to you. Over 4 months is way too long to wait to get repairs completed for the GC, your insurance company, and you because the repairs should be completed as soon as possible.

    You could argue that you are at least entitled to “overhead” because you coordinated the roofing contractor and fronted the money (or your credit) to complete the work and you should be entitled to 10% overhead for your role. The more you insist upon it, the more likely State Farm will cave in and pay it to you. Short of demanding it without backing down, they will not pay it.

    The best route is to get payment for your entire loss, with O&P in the estimate, paid to your mortgage holder and you. Once you have control of the claim funds, you can choose how to use those funds for the repairs.

    One of the best things you can do for yourself is to review your insurance needs and insurance companies ratings found under BEST AND WORST INSURANCE COMPANIES found at the top of this page.

  1474. April 25th, 2013 at 9:21 am #Randall Barrett

    SO my question is that I had three different roofing companies come out and they all agree that I have wind and hail damage. Last year My insurance company sent an adjuster out and the adjuster says that I don’t have any damage. obviously the claim is denied. This year the same insurance company sends an adjuster out and he says yes I do have wind and hail damage in multiple areas but the company sends an engineer out and now the company has denied the claim again saying yes I do need a new roof but they are claiming there is not enough wind and hail damage to warrant a new roof from them. IS THIS RIGHT? and can I do anything about it.

  1475. April 26th, 2013 at 9:03 am #Shannon

    Hi! My name is Shannon and my husband and I bought our home 18 months ago. It is 40 years old. It underwent a homeowners inspection at the time of purchase, and the basement was especially looked at given there were two “stair step” cracks. Upon further inspection by two different inspectors and structural engineers, the house was deemed structurally sound–the cracks were original to the house and were just mortar cracks, not uncommon for Wisconsin, where we live.

    Around Easter (three weeks ago) I noticed our front door to be sticky. I attributed it to the fact that the door was 40 years old, and it might finally be time to replace it.

    Last Sunday, we came home from church to find our basement flooded with what appeared to be raw sewage. We breathed a sigh of relief that we had purchased the additional sewer back up and sump pump overflow protection on our homeowners policy.

    We called our agent, who then directed us to make the mitigation attempts as quickly as possible. Roto Rooter was called, but quickly informed us after initial inspection that the problem was a foundation plumbing problem, under the basement floor, it had likely caused structural damage, seeing as the plumbing stack was directly next to the foundation footer for the I-beam. He referred us to a foundation plumber and repairs company.

    A mitigation team was called in to remove the biohazard.

    The next day, the foundation plumbers and structural repair company came and showed us how the leaking pipe underground had likely undermined the footer, and how now, we had a structurally compromised wall and our I-beam was protruding from the outside of the house.

    Our adjuster came directly after that. Upon seeing the damage, he dismissed our concerns regarding structural, telling me those were old. I showed him our recent inspections and how as of 18 months ago, the house had no problems. I asked him questions about our coverage, which he vaguely answered, telling me foundation problems were not covered.

    Later that day the foundation plumber and team came back and fixed the pipe. He showed me how (after the jackhammered and uncovered the basement floor) the water from the interior pipes would flood the footer and disperse beneath the basement floor. They fixed the pipe.

    Later, the foundation plumber took it on himself to call our adjuster and tell him that the two were related. The adjuster then called a structural engineer—a “buddy” of his.

    We hired our own engineer. Our engineer determined that the plumbing/sewer leak had disproportionately introduced a higher percentage of moisture on one side of the house, and as the ground thawed, the home, which for 40 years prior had always shifted and settled equitably due to uniform moisture/dryness levels, now did not. Thus, becoming for the first time, structurally unsound.

    The foundation plumber concurred with our engineer.

    After finally pinning our adjuster down, he back tracked and admitted our policy would cover the foundation damage as long as it was related to the sewer, not groundwater. But I had to have my neighbor, an attorney back him into a corner to do it.

    The insurance company’s forensic engineer came out yesterday. I am scared that he will rule on the side of the adjuster/insurance co.

    What to do? My home suddenly went to no value. We are scared. We don’t have the resources to take on a bully like this company. Where did we go wrong?

    Thanks for your advice.

    Shannon 🙁

  1476. April 26th, 2013 at 10:35 am #Jason

    Shannon,
    Your insurance company will put much more weight in their hired engineer’s report, even though that is entirely unfair. The insurance company is probably going to rely on the following language found in a typical insurance policy for lack of foundation coverage:

    8) Settling, Cracking, Shrinking, Bulging, Or Expanding — “We” do not pay for loss caused by the settling, cracking, shrinking, bulging, or expanding of:
    c) floors;
    d) footings;
    e) foundations;
    ———————————————————
    7) Collapse Or Impairment — “We” do not pay for loss involving:
    b) impairment of structural integrity, including but not limited to sagging, bowing, bending, leaning, or inadequacy of load bearing capacity;

    The wording of your policy, if it contains language common of nearly every homeowner policy, doesn’t consider foundations and underground pipes part of the insured structure.

    You didn’t do anything wrong. You have to guide your insurance company that your specific situation is covered by your policy and that a covered condition (the sewage break and damage led continuously to your foundation failure).

    You have a covered loss due to your sewer back up and sump pump overflow coverage and also likely the following policy language:

    n. Accidental Discharge Or Overflow Of Water Or Steam from a plumbing, heating, air-conditioning, or automatic fire protective sprinkling system.

    Your claim situation is very complicated and insurance companies rely on the preconceived notion that foundations are not considered a covered part of the property. They tend to rely on this principle no matter what. If there is a covered cause of loss that continuously and uninterruptedly causes foundation damage, the foundation damage should also be considered as covered damage. (Courts are divided on the topic of foundation coverage but tend to favor the insurance company). If you have further questions when you get feedback from the insurance company, just post again.

  1477. April 26th, 2013 at 10:39 am #Jason

    I did not insert the smiley face and it must have been inserted as part of the cut and paste function when I inserted the policy language. The smiley face is entirely inappropriate when discussing damage to a home. Please do not take any offense because that. No offense was intended.

  1478. April 29th, 2013 at 2:47 pm #luis

    hey i have a question i have a sinkhole claim the insurance company wants a copy of engineer contract to release the check thats sitting in the bank if i get a cheap engineer repair would i be able to pocket the extra money or no

  1479. April 29th, 2013 at 6:17 pm #Jason

    Luis,
    If you are being required to send documentation of the repairs, that would be your bank requesting it – not your insurance company.

    Are you sure the check is for an engineer relating to your sink hole? Typical home owner policies have this kind of wording in it:

    However, “we” do not cover the cost of filling sinkholes.

    Also, they apparently only want a contract to release the check. If you change your mind or find someone cheaper to do the repairs, that seems appropriate. Changes happen all the time.

  1480. May 2nd, 2013 at 10:59 am #stephanie

    Good morning,
    I’m located in California and have my homeowners insurance through State Farm.
    We purchased our house in 2008 and we’ve noticed cracking in the ceiling on family room and dining room. There is no cracking on the walls only in the ceiling. We believe the previous owner removed a wall which connected family room to dining room and this maybe what’s causing the cracking of ceiling. If this were the case, would our homeowners insurance cover the repair? Also when we bought the house we paid third party inpection to ensure home was in good shape.

  1481. May 2nd, 2013 at 12:44 pm #Jason

    stephanie,
    Insurance provides coverage for certain causes that result in damage. Cracks that appear without a covered cause occurring are not covered.

    A typical homeowner policy contains the following language that may apply to the cracks but this is difficult to determine without an on-site inspection:

    8) Settling, Cracking, Shrinking, Bulging, Or Expanding — “We” do not pay for loss caused by the settling, cracking, shrinking, bulging, or expanding of:
    a) bulkheads;
    b) ceilings;
    c) floors;
    d) footings;
    e) foundations;
    f) patios;
    g) paved areas;
    h) roofs; or
    i) walls.

    2. “We” do not pay for loss or damage to property covered under Coverage A or Coverage B that is caused by or results from one or more of the following excluded causes or events.
    b) construction, compaction, design, grading, remodeling, renovation, repair, specification, workmanship;

    If there is a covered event that resulted in cracks in your ceiling, it may be covered – but since you didn’t indicate why the cracks are present in the ceiling other than perhaps a removed wall, it is difficult to determine if coverage would apply.

    Only an inspection would determine if the ceiling cracks are covered. A claim would have to be made in order for an inspection to be completed.

  1482. May 2nd, 2013 at 12:47 pm #Jason

    The smiley face icon should not be in the prior post. It seems to have been added while copy and pasting parts of the language from a sample policy.

  1483. May 2nd, 2013 at 4:34 pm #stephanie

    Jason thank you for your prompt response. I will have inspection made and will keep you posted. You’re the vest. Thanks for the advice.

  1484. May 3rd, 2013 at 9:08 am #Amy

    we have been renting a house and it went into to foreclosure. the previous owner has told a few people he is going to burn it, we put renters insurance on it thru met life, if the nut really burns it will the claim be denied since we just got coverage.

  1485. May 3rd, 2013 at 1:13 pm #Amy

    Forgot to mention the bank advised me to get the rental insurance cause they heard the same rumors of the previous owner burning the house. Its a 5 bedroom 4 bath huge house full of stuff. We went with 50k on contents…

  1486. May 3rd, 2013 at 2:43 pm #Jason

    Amy,
    Fire is a covered cause of damage for insurance to apply. Just as long as you had no part in the fire, there should be no reason for it to be denied.

  1487. May 3rd, 2013 at 2:56 pm #Shannon

    Jason:

    I know we’ve talked before, but here’s a recap of our situation…

    Facts are:

    40 year old home. Evaluated by structural engineers in 2006 and 2011. Home is deemed structurally sound by both.

    Major plumbing leak under foundation. Located 2.5 feet from foundation footer supporting I-beam. Western and Southern walls shift.

    Major drought in Wisconsin in 2012. Rainy April 2013.

    April 20th 2013 plumbing leak and subsequent sewer overflow into basement.

    Plumbers, Foundation Experts and Civil Engineer first on scene all state home was damaged likely by disproportionate moisture levels, (from plumbing stack leak underground), thus house has differential settling .

    Insurance company’s engineer says it could have been the drought and could have been pre-existing, but not longer than 2011 and could have been the rainy April. But can’t rule out the leak. Inconclusive.

    Sewer overflow, sump pump and plumbing leaks leading to damage is all covered under a $50K endorsement.

    Who has the burden of proof? The homeowners to prove the leak caused the structural damage or the insurance company to prove it was the drought/rainwater?

    How heavily can I lean on the 40 year history of structural integrity to prove a preponderance of evidence that it would likely have withstood a drought and heavy rain given its history, thus the leak and its ridiculous proximity is the cause?

    Shannon

  1488. May 3rd, 2013 at 3:24 pm #Amy

    Thanks. .. My brother was in an explosion and im terrified of fire.. The previous owner is sick, terminal and he is a lil off the rocker. The bank took him very serious and stated i should too. We are moving asap but til we do Im half afraid to leave. afraid it will all be gone when we get back….

  1489. May 3rd, 2013 at 5:58 pm #Jason

    Shannon,
    You have an all risks policy (except for those things that are excluded). You are asking who the burden is upon and that would be for the insurance company to prove an exclusion, rather than coverage, applies.

    Any good insurance company should look for coverage as their first and foremost responsibility to their customers instead of looking for ways a claim should be denied.

    If the insurance company engineer says it’s inconclusive, then that should be enough doubt that the sewage might have caused the damage. Since they can’t rule it out, they should go with the premise that it caused the damage and look toward the policy to see if the sewage condition caused a covered loss or not. Since part of your claim is already covered (sewage cleanup and related damage), then that should prompt them to then address the foundation damage.

    Weather changes, including high moisture and low moisture levels in your soil, have been occurring to your house for 40 years. That happens with every house in the world. You had a specific event that seems to be of uninterrupted duration that caused damage to your foundation.

    However, underground pipes and foundations are not considered covered property based on the language of most home insurance policies. Damage to property not covered by the policy (underground pipes and foundations) would leave that damage as uninsured regardless if an insured event occurred to cause damage.

    It would be good for you if the insurance company covered your foundation concerns but I’m just letting you know the applicable wording contained in your policy so you know what to expect.

  1490. May 5th, 2013 at 10:49 am #Joseph

    Summary: Contractor caused flooding in home. Contractor hired construction company to make repairs. Repairs completed. We submitted reimbursement requests and quotes for cleaning of floors, draperies, home furnishings, etc. Contractor’s insurance company has agreed to pay all requests but only if we sing a Release Document. This document clearly states it is contractual and we would release insurance company and contractor from any future claim on seen or unforeseen items. Our insurance agent has advised we not sign the Release document in the event some unforeseen issue appears. How do we obtain funds from insurance company without signing release document.

  1491. May 5th, 2013 at 11:14 am #Jason

    Joseph,
    In order for you to get the funds, you will have to sign the release. Before you sign the release, you need to make sure there are no overlooked items of damage. If you carefully review everything that may possiblty be unseen damage, then you should have no concerns signing a release.

    The other option available to you is to submit this through your home insurance company and then you won’t have to sign a release.

  1492. May 5th, 2013 at 11:58 am #Joseph

    Thank you for the reply.

    This still sounds like a Catch 22 for me. While most of the walls in the area of the flooding were partially removed to get air on the studs and prevent mold from growing, there is always the possibility that something was missed. Plus my Ins Agent is counseling me to not the sign the release document – in case something was missed. My belief is that if I sign this document and then other damage is discovered, I will have signed away and further recourse on the claim.

  1493. May 5th, 2013 at 12:10 pm #Jason

    Joseph,
    Then your other choice is to file it with your own insurance company. If the damage was done by someone other than you, your insurance will collect that amount from the at fault party – including collecting your deductible. It seems you insurance company is your best bet if you don’t want to sign a release.

  1494. May 7th, 2013 at 6:48 am #Mike

    I had fire damage to house. Insurance company sent an independant insurance adjuster out. we agreed to gutting out mulitple rooms and agreed to a verbal figure. The adjuster then sent his estimate and report to his supervisor in another state. I was then sent out a much lower estimate and figure. When I called the original adjuster they stated that is not the estimate they sent in. Turns out the supervisor lowered the estimate and changed mulitple items being replaced to being cleaned based upon looking at the photographs. Can they do that?!!! Supervisor never even came to house. Does not seem right they send out their own adjuster and then changes his recommendation??

  1495. May 7th, 2013 at 7:52 am #Jason

    Mike,
    Yes, they can make changes that are appropriate. Replacing something that can be cleaned doesn’t make sense.

  1496. May 7th, 2013 at 8:25 am #Mike

    Yes, but I do not think they can make that determination based on never seeing the damages and solely making that change based upon viewing photos. Even more so when their own adjuster sent in a different estimate after viewing damages.

  1497. May 7th, 2013 at 8:34 am #Jason

    Mike,
    Photographs taken by the adjuster on site can often be more useful than an in-person inspection. A high resolution camera that a person can zoom in on details is a very important tool.

    If you don’t believe their assessment is correct, let them know that and be prepared to let them know why you think things should be different. The main thing seems to be whether something can be cleaned or not – is that correct?

    As far as higher or lower estimate, what should matter to you is finding a contractor that is able to restore your home for what the estimate allows for.

  1498. May 11th, 2013 at 11:14 pm #Chris

    I have a condo (rental) in Las Vegas, NV. The condo is on the second floor. My water heater sprung a leak, which resulted in water damage to the condo below.

    As soon as the water leak was discovered, the hot water heater line was turned off. I had a water heater tech out that same day (Sunday) and they replaced the water heater the next day (Monday).

    I spoke with the condo neighbor below, and recommend she call
    her insurance, and she did call them. They sent people to dry her condo/patio which had the damage.

    Meanwhile, I do not have insurance on my condo…..but there is no additional damage to my condo….luckily!

    So, now I received the estimate of repairs along with pictures of the damage from my neighbor’s insurance (Nationwide)….totalling nearly $6,000 in damages.

    My main question is “Am I liable”…. I’ve read so many similar situations online about this, and I’m just not sure how to procede.

    One posting explained ‘liable’ and ‘negligent’…and said that in order to be liable, I would have to be negligent. They said that a water pipe breaking is similar to a casualty, or act of god, whereby since I didn’t expect the pipe to break, and nobody would have knowledge of this, I’m not negligent, hence I’m not liable for the damages.

    The posting literally said:
    “Were I your liability claim rep I would deny the claim to your neighbor. The denial letter would simply say that findings indicate no negligence. There would be no details given about anything ”

    Any guidance would be appreciated…. I’m thinking I should maybe contact a lawyer? I just don’t know….

    Thank you for your time!!

  1499. May 12th, 2013 at 12:49 am #Jason

    Chris,
    Just because it’s your water heater and the water originated from your unit, you are neither liable nor negligent for the lower unit’s damage.

  1500. May 12th, 2013 at 11:36 am #Chris

    Hi Jason, thank you so much for that statement!! I’m just curious what would you recommned I do next? I’ve been looking for some kind of standard form or something that I can send to Nationwide insurance basically stating that I’m not liable or negligent…

    Any other advice would be so helpful and appreciated.

    Thank you again for your fast answer last night!! I so appreciate it!

  1501. May 12th, 2013 at 12:00 pm #Jason

    Chris,
    There is no standard letter. Nationwide is being overzealous and should not be sending you any letters to collect from you. You can either ignore the letter (and any future letters) or you can write them back indicating you are not liable because nothing you did, or didn’t do, resulted in the lower level water damage. You may point them toward the manufacturer of the water heater as a possible party to collect from.

    You could get an attorney to draft the letter for you and they would know exactly what to do and it shouldn’t cost you very much.

    The attorney would likely ask Nationwide to express their position why they think you would be responsible for the lower unit’s damage.

    From what you described, you have no legal obligation to pay for the damage. You would only have a legal obligation if you were sued and they were awarded a judgment. For them to secure judgement based on the information you provided is extremely unlikely. The burden is on Nationwide to prove your negligence for the water damage and if the water leak occurred from an accidental water leak, they would not be able to prove negligence on your part.

  1502. May 12th, 2013 at 1:00 pm #Chris

    Jason, THANK YOU sooooo much for that information. This has been on my mind ever since this first happened….and when I received their ‘bill’, my heart sank, and again it’s been even MORE on my mind!

    I can’t thank you enough!! I really really appreciate you taking the time to respond to my questions and help me.

    I’ll let you know how things go….

    Thanks!!

  1503. May 18th, 2013 at 2:06 pm #Steve

    I was burning brush with an activated fire permit. Heavy winds (45 mile gusts) caught the fire out of control. The fire burned across my property destroying a boat and other personal property but all building structures were untouched. The fire jumped a river adjacent to my property and burned down a neighbors home and damaged 2 others.
    My liability is 100k and I’m sure not enough to cover the total damage. Two of the other properties have insurance coverage but the one that burned down had been cancelled due to condition. My question, how much trouble am I in? My insurance has indicated it will pay but what do I do about everything above and beyond?

  1504. May 18th, 2013 at 3:08 pm #Jason

    Steve,
    Here is an example, the first house damage is $100,000, the other 2 are $50,000 damage each – total of $200,000 fire damage to property of others.

    Your insurance will pay the one with the most damage $50,000 and the remaining 2 will get $25,000 each for a total of $100,000. You are responsible for each person’s excess damage between your total coverage and the total amount of damage.

    Your insurance company will attempt to secure a release of damages above your insurance coverage from each party involved. Your insurance has a duty to protect you from the excess exposure, but their efforts might not prevent any of your excess exposure related to the problem of not having enough coverage. Your insurance company at least has to give their best effort to protect you. You are their client and that is what they owe to you because you have insurance with them.

    If you have any other property insurance with the same company, or even a different company, you may have additional liability coverage. This may be the case if you have a rental property or a cabin someplace.

    In order for the other uninsured property owner and the insurance companies to force you to pay any amount, they would have to secure a judgment against you first. Prior to a judgement, any payments or settlement from you would be voluntary.

    If there remains an amount above your insurance limits that you owe to others, you may be able to settle with them for a sum of money less than the total amount of damage.

    If the total damage is more than you can handle, you may want to retain an attorney but that is entirely up to you.

  1505. May 19th, 2013 at 10:46 am #Steve

    Thank you for your prompt response. By retaining an attorney do you mean bankruptcy?

    I hope we can work it out we do live in a low rent district in the country.

  1506. May 19th, 2013 at 10:56 am #Jason

    Steve,
    Bankruptcy is always an option. No, you don’t need to retain a bankruptcy attorney until, and unless, you are actually going to file bankruptcy. I didn’t mention that option because it is way too soon to look at that option until you know you actual exposure.

    A general attorney, perhaps to help with your negotiations to settle any amount over the insurance limit. It’s still too soon for negotiations to settle because you don’t know what the excess amount is – if any.

    (Please note that many states have stream-lined the bankruptcy process so people can file the bankruptcy themselves without the need for an attorney. Check your state for the bankruptcy process without using an attorney.)

  1507. May 19th, 2013 at 11:26 am #Steve

    Thank you so much Jason. You have helped ease my mind about this process, God bless you.

  1508. May 30th, 2013 at 2:37 pm #jeff

    I had a insurance claim 7 years ago on storm damage to our home. Included in that was roof replacement of the home. the adjuster said there was $6500 in damages, we received a $2500 check minus our $1000 deductible, the balance to be paid upon completion of repairs. We were unable to have the work done because of bad financial times and used the money, making some of the repairs myself as I was able to. 7 years later a storm has hit again,really doing a number on my roof that wasnt replaced previously. I am getting estimates for work and they are coming in higher than $6500 that were for much more that just this roof I am having estimates done on. Am I able to call in another claim on the roof since it has been some time and I don’t believe they allowed enough originally?

  1509. May 30th, 2013 at 6:24 pm #Jason

    Jeff,
    You repaired your roof 7 years ago. It appears you have a claim because of recent storm damage. Your estimates for the roof repairs are higher than $6500.

    If you are asking if you can do something about your claim 7 years ago, the answer is no. If you have a different question, simply ask.

  1510. May 31st, 2013 at 3:25 pm #jeff

    I only repaired the roof, not replacement which the original claim did state replacing the roof.I only accepted and used the partial half of the money in the claim
    that was sent to me, but there was another garage roof included and siding replacement and damage to other structures as well which I am not including in this new claim. Just was unsure, since the roof was not actually replaced as stated in the first claim. I appreciate the help. Thanks.

  1511. June 7th, 2013 at 5:45 am #Barbara Lallement

    My city recently had a huge hail storm, with very high winds and 2 torando’s.
    My insurance adjuster, Farmers, was out here yesterday and he totaled the roof on my shed, but not on my house.
    This does not make sense to me and he is not returning my calls.
    I have had a roofer out and he said that both roofs were totaled.
    What should I do, I have no one to advise me.
    Barbara Lallement

  1512. June 7th, 2013 at 7:11 am #Jason

    Barbara,
    Obtain written information from the contractor about the damage on the roof the insurance company is not totaling and relay this information to your adjuster. If you cannot communicate with your adjuster, speak to his manager. If you cannot communicate with his manager, contact the manager’s manager. You will have to do some leg-work to get the other roof included in your claim.

  1513. June 7th, 2013 at 7:35 pm #Scott Harris

    Trying to help my mom out. She just lost her husband. My question for you is:
    We discovered she was losing hot water pretty fast. she just found out she has a hot water leek and the plumber told her she would have to run new copper through the walls. The leek was located in the kitchen. This is the important part You couldn’t see the leek but you could feel how hot the hardwood floor were in the kitchen. She called her insurance company and they said she was not covered because you could not visual see the leek. Need you help please!

  1514. June 7th, 2013 at 8:15 pm #Jason

    Scott,
    The insurance should cover the direct damage because of water escaping from the plumbing system. If the copper pipes are corroded in the entire home because of acidic (or other corrosive) conditions in the water that cause wear to the pipes, the insurance won’t cover that.

    There are certain items of home ownership that fall under the parameters of maintenance and if pipes need to be replaced because of maintenance, that is not an insured condition.

  1515. June 8th, 2013 at 7:42 am #Steve

    Jason
    Update on my claim. My insurance investigator told me that he would not be seeking any releases to protect me. The following day he sent me a letter telling me to seek the services of an attorney.
    I did hire an attorney and his first impression is that the $100k may be close to enough based on the value of the burned structures. I have a separate $15k policy with the same insurance on a boat that was totally consumed and to date have not received a dime. I was told that my policy does not cover landscape loss or field fencing. In addition to a couple thousand in personal loss I have a dozen trees that need to come down and be disposed of as well as the remains of the boat motors and trailer. Is it typical that the cost of clean-up and disposal is my liability?

  1516. June 8th, 2013 at 9:58 am #Jason

    Steve,
    As necessary, your insurance should be obtaining releases from the victims to protect you. That is part of their responsibilities to you. That is what insurance is for – to protect you from liability claims.

    Your boat should be covered and paid for if its loss was due to fire. Your boat is likely covered as an endorsement to your home owner policy.

    You would have to review your policy to see the coverage that would apply to trees, landscaping, and fencing.

    Trees would be under the heading of “Trees, Plants, Shrubs, Or Lawns”. Your policy should provide for coverage for any of your trees damaged by fire, but your policy may also have a limitation for this coverage, such as 5% or $500 for any one tree, shrub, or lawn. There may be other limitations that your specific policy contains pertaining to trees.

    Going to the debris removal of those fire-burned trees, the “Debris Removal” heading of your policy excludes debris removal coverage for trees damaged by the cause of fire.

    The fencing would be under the heading in your policy of “Coverage B — Related Private Structures” and should be property covered due to loss by fire.

    Your claim is rather complex in that it deals with liability for the damage to the property of others, your boat, trees, and fencing and the best way to determine what is covered and what isn’t is to read and understand your policy. You cannot just take the word of the adjuster if he says there is no coverage for certain property. An adjuster can be confused by the policy language, and even some attorneys may not fully understand the coverage and limitations of your policy.

    The best person to read and understand the policy is you because you are the one that has the most at stake in the outcome of your claim for property damage and for claims against you.

    (Any advice, statements, and determinations provided in this post are based on my personal interpretations of coverage based on a standard home owner policy as it applies to your claim and the claim of others. Your specific home owner policy and the specific details of your claim are not known by me – this means your policy may be entirely different than the one I am referencing. You should not rely on the information of this post, but use the information in this post only as a guide.)

  1517. June 8th, 2013 at 1:01 pm #Vonita

    Our home caught fire Dec 6th, 2012 while we were on vacation in another state; it was considered a total loss by our insurance company. Since then my family and I have been living in hotels at our own expense and have had very little communication with our insurance company. We’ve not been reimbursed any additional living expenses and they will not return our emails or phones. We contacted the county fire investor who informed us that a cause for the fire couldn’t be determined so it was a police investigation. It’s been 7 months and they can’t even say if its arson, how long should we allow this to continue?

  1518. June 8th, 2013 at 2:47 pm #Jason

    Vonita,
    What you’re saying is that you have called your insurance company repeatedly in the last 6 months, left messages to call you back, and they have not returned any calls to you.

    Another thing you are saying is that of all the e-mails you have sent your insurance company, they have replied to none.

    I don’t believe they have not been in contact with you by e-mail, telephone, an adjuster, investigators, and/or by mail.

    Did the insurance company ask where you were on vacation, who you were with, and how long the vacation lasted? Did the insurance company ask what mode of transportation you used to arrive at your vacation spot?

    And finally, you asked how long should you allow this to continue. Any investigation including arson, crime, or insurance determination should have all been completed within 2-4 weeks so this should have been concluded by the first day of this current year. Instead of living in hotels, you may want to find an apartment to rent so your out-of-pocket expenses are not so high.

  1519. June 10th, 2013 at 6:27 am #randy

    the neighbors tree feel on our power line that comes from power pole to our house knocking out our power. it was the hottest weekend so far 109 degrees. we had to get motel room. should the next doors homeowners insurance pay for our motel room ?

  1520. June 10th, 2013 at 6:40 am #Jason

    randy,
    No, your neighbor’s insurance does not provide insurance protection for your property – only your home owner insurance covers your property. Additionally, your neighbor didn’t do anything that caused the tree to fall on your power lines so he is not liable for your damages or expenses.

  1521. June 10th, 2013 at 7:14 am #randy

    unfortunately its not the reply i wanted, but thanks anyway.

  1522. June 11th, 2013 at 1:15 am #D Lockett

    after hail damage had shingles replaced and now they cannot match the gutters?

  1523. June 11th, 2013 at 6:08 am #Jason

    D Lockett,
    Gutters are fairly standard and can be rolled out at the job site from an aluminum roll. If there is a concern with your contractor doing the repairs properly, you should discuss those concerns with your contractor.

  1524. June 13th, 2013 at 8:20 am #Frank

    Hello all,

    I recenetly had my car broken into. It was parked in my driveway and was robbed overnight. I had gotten back from college that day but it was raining all day so I was just going to bring all my stuff in the next morning.
    Sure enough I come out get inside and EVERYTHING is gone. Cash in glovebox, tv, garmin, golf clubs, all my clothes.. shoes.. hats.. sunglasses.. etc.. We made an initial police report but the lady was very rude and unhelpful. We only listed the most expensive items. 3 days after the report there was a news paper article in the Louisville News (The Courier Journal) that said to be on the look out for a car robber. He had hit over 30 cars in the past 48 hours. I have a copy of that article for the insurance company as well as my police report that dated 3 days prior.

    The insurance agent we have spoke with,(AAA) said that was fine and that people figure out they are missing more things then initially reported all the time. As far as receipts go, I have some but not all recipets and she said that would be fine as well. She said to look up the newest product available on the market today and list the price and a copy of link to the website on the paperwork she gave me.

    For example I had PING irons so she told me to look up the newest PING irons and list the price and website on the sheet. She said to do that for every item and then they would give me a depreciated value until the item was purchased, and then I submit the receipt and get fully refunded.

    I just want to know if any of this sounds correct and what steps I should take going forward so that I can get fully refunded and not ripped off like alot of people do by the insurance companies.

    Thanks in advance guys!,

    Frank

  1525. June 13th, 2013 at 10:13 am #joe

    My neighbor has an old garage, and it was damaged last nite by storm, collapsed to the side from winds. would this be a covered loss by her homeowners insurance..she has state farm
    thanks’
    joe

  1526. June 13th, 2013 at 5:41 pm #Jason

    Frank,
    Just make sure the items that you represent to the insurance company are what you actually had stolen. Then make sure you and the insurance company agree on the replacement value of each item. They will then pay you a sum of money based on the age of the stolen items.

    You can then take the insurance funds (and some money of yours) and replace the items. All you need to do is send in your receipts to the insurance company so you can collect the difference between what they already paid you and the actual cost of the items. They should also be paying for your sales tax cost besides the purchase price of the items.

    This should be pretty close to what they explained to you as far as the process goes. You may have a time limitation on the amount of time for you to request the recoverable depreciation so make sure you ask your adjuster how much time you have.

  1527. June 13th, 2013 at 6:00 pm #Jason

    Joe,
    Sometimes insurance companies exclude certain older structures from coverage, even if the insurance company insures other buildings. Your question would best be asked of her insurance adjuster.

    If the collapse was from wind – wind is a covered cause of loss.

  1528. June 14th, 2013 at 4:44 am #Frank

    Jason,

    Well finding the newest model of the clubs I had is going to be fairly pricey on the insurance end. As you know, golf is an expensive game. So for instance. If I had calloway Clubs. Newest Calloway Irons are 899.99 New calloway driver 299.99, fairway woods 150.00 each, wedges 150.00 a piece, putter 100.00 bag 100.00 golf shoes 100.00, balls 40.00. You can see where that would add up. Is that all fine with the insurance company? Im suer golf clubs is a fairly common stolen item?

    thanks,
    Frank

  1529. June 18th, 2013 at 4:04 pm #Jeanette

    Dear Vonita:

    We have handled this very type of claim resulting in a case. The matter went to trial, and we were able to successfully resolve the matter for the insured. This is very serious – because the delay significantly harms the insured. If you have provided the insurance company with everything they requested, they should have concluded their investigation by now.

    The California Regulations regarding claim handling may be found and downloaded from our web site, vklawyers.com, or from the California Department of Insurance.

    We wish you the best. We understand the heartache that results from such delay.

    Best, Jeanette Viau

  1530. June 18th, 2013 at 4:12 pm #Jeanette

    Dear Scott Harris:

    I noticed your post about your mother’s hot water leak. Please note that some policies do cover wear and tear. For example, the policy may state:

    “a. We provide limited coverage for accidental direct, distinct and demonstrable physical water damage of covered property from direct contact with water, but only if the water results from. . .

    (4) a sudden and accidental discharge. . . or release of water. . . from within any portion of. . . a plumbing system. . .

    b. The limited coverage for water damage described at subsection a. above applies even if the sudden and accidental discharge. . . is caused by. . .

    3. Wear and Tear or Mechanical Breakdown. . . .”

    Therefore, it is very important that your mother’s insurance policy be reviewed. Although wear and tear is often excluded, some policies (including Farmers) do provide limited water coverage covering sudden and accidental damage and loss due to wear and tear.

    Best, Jeanette Viau, Esq. at jlv@vklawyers.com

  1531. June 18th, 2013 at 4:58 pm #Jeanette Viau

    Mike #1495:

    If your claim is in California, the California Fair Claims Settlement Practices Regulations provide that if you obtain a written estimate that is higher than the carrier’s, then:

    “[T]he carrier shall: (1) pay the difference between its written estimate and a higher estimate obtained by the claimant; or (2) if requested by the claimant, promptly provide the claimant with the name of at least one repair individual or entity that will make the repairs for the amount of the estimate. . . or (3) reasonably adjust any written estimates prepared by the repair individual or entity of the insured’s choice and provide a copy of the adjusted estimate to the claimant.”

    You may review and download the Regulations at the California Department of Insurance website.

    Also, we have handled cases where the supervisor reduced the independent adjuster’s estimate, and redacted scope items – where the supervisor had not actually inspected the damaged property. There was no valid basis for the supervisor’s reduction and redaction. The jury did not like that at all, and the carrier could not support its position. Just based on the bare facts at this point, we believe you are justified in questioning the carrier’s conduct. Claim handling is very fact intensive, however, and it is really not possible to comment on the validity of the carrier’s conduct without more facts.

    Best – Jeanette Viau, Esq. jlv@vklawyers.com

  1532. June 18th, 2013 at 8:23 pm #Jason

    Jeanette and Scott,
    Please take notice that damage that results from a pipe that is worn out due to corrosion or a high PH level in the water and causes water damage is covered damage. The need to replace weakened pipes in the rest of the house that have not corroded entirely are not covered as part of damage from a claim.

    As Jeanette suggests, the immediate pipe that burst may be paid for by insurance but the entire cost of replacing all the pipes in the home will not. This is more of general maintenance and insurance does not cover maintenance concerns.

  1533. June 18th, 2013 at 8:52 pm #Jason

    Jeanette,
    Mike’s post, of 1497, rather than 1495 does not indicate in which state the loss occurred. If you are going to specify what happens in CA, you might as well specify what will happen in the other 49 states as well. Or else, perhaps it would be reasonable to determine in what state Mike has the claim in order to provide state specific advice.

  1534. June 21st, 2013 at 1:44 pm #Tanya M

    We were told would recover our depreciation amount and save money (to help cover our huge deductible) if we did most the work ourselves. We knew we woudl lose the 20% OH&P but we have several business connections to getting materials cheaper. We turned in first work order for fence. Estimate was $4763.43 to replace and depreciation was set @ 50%. We were issued Check for all repairs but of that bulk check $2381.71 was issued for fence. We purchased materials @ $1700 and issued invoice to our insurance agent for this and remaining amount of $3063.43 for labor. Thus the total of $2381.71 Deprciation amount should have been refunded minus the OH&P should have been $1429.72 correct? They have issued a check for $1029. When I ask for the math he simply directs me to the loss worksheet that does nothing more than give me total replacment cost then description of work not completed and breakdown of settlement again. Makes NO sense> Please help me understand what I am missing. Our OH&P is 20% for 10% each.

  1535. June 21st, 2013 at 3:58 pm #Jason

    Tanya,
    You need to present your entire claim, including what you were paid, what you should be additionally paid in a format that you can easily explain to your insurance company. The need to know what is expected and what you need to be paid to make your claim settlement fair to you guys for doing the work.

    If you can’t get anywhere when you present what your expectations are to the claim adjuster, go to his manager, and the manager’s manager if needed.

    Take control of your claim and don’t let them shove their meaningless and baseless numbers at you. Use your numbers and have it make sense to the adjuster, and firmly insist that you are paid for labor and materials.

  1536. June 21st, 2013 at 7:43 pm #jim

    we had wind and hail damage to our house this week. the adjuster claims he is responsible for only the physical damage. My issue is that the repair will not make my house two colors closely related as the original color of the vinyl siding can no longer be matched. so i will have two sides new and two sides not new. is the insurance company obligated to make me whole? i was not two tone colored prior to the storm but will be after “their fix”.

  1537. June 21st, 2013 at 7:46 pm #jim

    we recently had a wind and hail storm that damaged our home. prior to the storm our house had one color of vinyl siding all the way around. about 20 years old so has the normal fade. now the insurance company wants to replace to sides only that were physically damaged from the storm and leave the other two not matching the new ones as there is no way to match it. is the insurance company obligated to make me whole again, in other words one color as the house was prior to the damage?

  1538. June 22nd, 2013 at 7:59 am #Jason

    Jim,
    With wind and hail damage storms, it is common for only 1 or 2 sides to become damaged from hail and wind. The sides that are damaged are being paid by your insurance to be replaced. The 2 sides that are not wind or hail damaged are not being paid to be replaced. Your policy only covers direct damage.

    You are talking about an indirect and undamaged condition of your house if you have existing siding that doesn’t exactly match your replaced siding.

    If you want an explanation how matching is addressed and already explained in this forum, please review post #1467. (Although that post is about flooring, it applies to roofing, siding, and interior painted surfaces as well.)

  1539. June 23rd, 2013 at 4:49 pm #Jack

    We were away on vacation (end of May). When we returned there was a foot of water in the basement. Reported the claim to AllState. For 3 days I called my agent (Chuck) a few times to get guidance on our emergency and what to do. Chuck’s assistant answered every time. She offered to send the adjuster a message to call me. Chuck calls me to ask me to stop calling his office and to wait for the adjuster to come out. He said to do what I needed to do and to keep receipts. So we called Service Master to come out to help us.
    I didn’t hear from anybody. 2 weeks later the adjuster calls me to tell me that it wasn’t necessary for him to come out to the house because I didn’t have a water back up option in my policy. The adjuster offered to add it for ‘future instances’. I asked the adjuster why he waited this long (2 weeks). He said my agent should have told me I didn’t have this coverage.
    My wife and I had never heard about this water back up option. Chuck is saying we declined it. However, Chuck never offered or asked if we wanted it (didn’t give us the option to add it!).
    So now we are expecting a high bill from Service Master. We have damaged walls and personal items.
    What is your advice?

  1540. June 23rd, 2013 at 5:47 pm #Jay

    My home was destroyed by a tornado. I have Farmers insurance. I was advanced 60% of my policy limit for personal property. I was told if I do my inventory AND spend the whole 60% keeping receipts then I could receive the 40% balance of my personal property limits if my inventory added up the the 100% after depreciation. Is this correct? Do I have to spend the entire balance of the advance before collecting any more of my personal property money? It took years to acquire my property and is going to be difficult to replace everything especially while living in a rental with rented furniture, while going through the rebuilding process.

  1541. June 23rd, 2013 at 6:38 pm #Michael

    Hey there! I really need some help. (I sent an email to you as well)

    I live in my grandmother’s house alone. She moved out in August 2010 and I moved into her house in September 2010. (I used to live with my grandmother years ago but moved out in 2008 but left a good portion of my possession at her house). My grandmother moved to the nursing home in August 2010 but still carried a homeowner’s insurance policy from Hartford on her house / personal property.

    My house (grandmother’s house) was broke into on May 15, 2013. LOTS of my stuff was stolen – electronics, watches, clothing, etc. I made a police report that very night. My mother is my grandmother’s Durable Power of Attorney, so she filed a claim with Hartford on my behalf. We had to itemize and value everything that was stolen.

    Hartford asked if anything of my grandmothers stolen and we told Hartford “nothing from what we could tell.”

    Hartford has denied my claim stating there was not established household since she moved out a month before I moved in. Can they do this? Please help me – I really lost a lot of stuff in the burglary.

  1542. June 23rd, 2013 at 9:26 pm #Jason

    Michael,
    I believe a response was sent to you from the e-mail you submitted. Bottom line is that it is likely they can take the stance that they took. A review by an attorney may be your best bet at this time.

  1543. June 23rd, 2013 at 9:34 pm #Jason

    Jay,
    You are provided a down payment (60% of total) in order to replace the items you had. You likely lost more than your personal property coverage level so it would be in your best interest to replace all the owned possessions you want or need for your current and future needs. Keep receipts and submit copies of your receipts to your insurance company.

    If you need more clarification of your options and what is required of you, ask those questions directly of your claim adjuster and if you need special exceptions, obtain those exceptions, in writing, from your adjuster.

    Please take the time to review the BEST AND WORST INSURANCE COMPANIES at the top of this page because you may want to consider an insurance company change when you find out more about your current insurance company ratings by others.

  1544. June 23rd, 2013 at 9:48 pm #Jason

    Jack,
    The ultimate person responsible for your insurance needs and coverage is you. Not your agent, not your friends, not your neighbors. If you don’t have a certain coverage, it is difficult to determine why, but the why doesn’t matter after the fact.

    The assumption is that the water damage claim you suffered was due to sump pump overflow or water backup, but since you didn’t clarify this, it is impossible to know. If that was the cause of the water in your house, that may be the reason you don’t have coverage.

    There are not many alternatives you can choose other than service master to take care of water damage. Do they cost a lot? Yes, they do. Regardless of insurance or not, you needed someone to take care of the water damage. They reduced the damage level and/or prevented additional damage so service master was needed in your case.

    The thing is that you need your agent to be watching your back and you need a good company when you have a claim. Look at the top of this page and the area of THE BEST AND WORST INSURANCE COMPANIES and determine if there are better companies (with better agents) that you should be with.

  1545. June 24th, 2013 at 4:23 am #Jack

    Jason, thank you very much for your candid feedback. While we were away we heard of strong wind/storms and power loss in the area. It is hard to determine what/when the water back up happened. But yes, the sump pump had to be replaced after our return home.

  1546. June 28th, 2013 at 4:09 am #Don

    We have Metropolitan for home owners. Back in November we removed a underground fuel storage tank which had been emptied nearly 10 years. The company found pin holes in the tank and advised us to contact insurer because there could be water and soil contamination. Metropolitan said our policy had a exclusion for pollution since 2006 but they would send someone to take soil & water samples. After sending a scientist and engineer to bore holes and take soil and ground water samples they found the contamination started nearly 20 years ago. They said they would pay for the cleanup of the years we were insured up to the date of the exclusion and that we should contact prior insurer for coverage of those years. My question is can they stop paying from the 2006 exclusion date or should I pursue them since I do not think an exclusion applies to a preexisting condition. We live in NY.

  1547. June 28th, 2013 at 8:23 am #Phil

    This is related to water damage.

    Two weeks ago we had a storm that caused water damage to two separate but geographically related areas in our house (Area A and Area B). A roofer identified easily seen loose shingles as the cause of the water entering the house for Areas A and B and fixed the problem. A week later, a second storm caused water to enter into our house through Area A but not Area B. The roofer returned and identified a second issue that was not as readily apparent as the loose shingles – an issue that likely caused the water to enter our home and damage Area A during both storm events.

    The first incident involved mitigation and repair; the second incident involved only repair (no mitigation).

    Our adjuster says these would be two separate claims as they came out of two separate storm events. I see these as both related to the first incident and the two issues that caused damage from that incident – the second issue just took a week in order for the issue to be properly identified – and should be included in the same initial claim.

    Is there a proper way to argue to the adjuster that these should be covered under a single claim, rather than two separate claims? Is there any additional support I can provide to make this argument? Or do I have no legs to stand on?

  1548. June 28th, 2013 at 11:50 am #Nancy

    We live in Texas and we claimed our roof for wind and hail damage. The roofer quoted us two prices one for 25 yr shingles 7500.00 and one for lifetime shingles 9000.00 we chose the 25 yr. The roof was repaired and now the roofer is going back to the insurance company for the depreciation value and stating that the 25 yr shingles cost 9000.00. Can you please advise what is going on. We need to make a sound argument we have the paper work stating what we agreed upon with the amount. We do not want to be part of anything illegal. Please advise.

  1549. June 28th, 2013 at 7:19 pm #Jason

    Don,
    An attorney would be the best choice to ask the questions you have about coverage, which insurer is liable, and about the start and stop points of clean-up efforts. I can’t resonably understand how they know what is their cleanup responsibility for the years you were insured with them until the exclusion was applied.

  1550. June 28th, 2013 at 7:33 pm #Jason

    Phil,
    Your best option is probably an attempt to convince your insurance company in a logical and organized way why your claim should be 1 claim rather than 2. They have 2 separate occurence dates and it will be somewhat difficult to have them change their position.

    If you firmly believe in your position and they adjuster will not budge because they won’t, or can’t, consider it another way, talk to their claim manager about your position.

    If the claim manager won’t budge, write a letter to the CEO of the insurance company and present your position in a logical and conclusive way that the claim should be one occurence and not two.

    A good point to argue is that although water entered at 2 different times, the total damage was not increased because of the secondary storm. And since no new damage occurred that is separate from either date, only one claim should be applied for the total of the damage. (The facts of the damage may not be accurate to what actually happened, but it may be a good arguing point.)

  1551. June 28th, 2013 at 7:47 pm #Jason

    Nancy,
    Contact your insurance company and let them know what you know. If you have copies of those quotes, offer to send those quotes to your insurance company. Also, let your insurance company know that the shingles applies were the 25 year shingles.

    You should not get into any trouble because you cannot control the actions of your roofer in his billing practices. Although the roofer may be trying to collect more money than he is owed, it may also be a mix-up in the roofers records. I don’t have enough information to determine what is actually going on.

  1552. July 1st, 2013 at 8:19 am #Judy

    In April we had a hail damage to our roof and siding, roof was replaced no problem. But my 35 year siding has a similar match, they we only replace 2 sides and will paint the other 2. How can you match and it look as good as all new siding. My 1st claim and im not sure where to turn.

  1553. July 1st, 2013 at 9:05 am #Jason

    Judy,
    Matching answers can be viewed in post numbers 1541, 1467, 810, 690, and 521.

  1554. July 9th, 2013 at 5:59 am #Michele

    Last night, while at the dining room table, our ceiling fan (Very high ceilings) crash to the floor. It hit the dining room table and landed across two chairs. The fan was on prior to the crash. There are now exposed wires in the ceiling and the ceiling area where the fan was located is damaged. Will my homeowners insurance cover the repair and a replacement dining room table?

  1555. July 9th, 2013 at 6:36 am #F M CONTE

    PLEASE ADVISE WHO YOU ARE COVERED BY? iS IT A hOMEOWNERS FORM ?

    IF IT IS A HOMEOWNERS FORM, BARRING ANY WACKY EXCLUSION I WOULD SAY IT IS COVERED, THE DAMAGE AND THE FAN SHOULD BE COVERED I MIGHT THINK THAT THE ELECTRICAL REPAIR PART MIGHT NOT BE COVERED, BUT THAT SHOULD BE A SMALL PART OF THIS.

    I TRUST YOU ARE REPRESENTED BY AN INDEPENDANT AGENT WHO CAN WORK ON YOUR BEHALF.

  1556. July 9th, 2013 at 6:47 am #Jason

    Michele,
    If you have a standard homeowner policy, the most applicable language in the policy for your loss has falling objects as a covered cause of loss; however, it seems to exclude the type of loss you explained:

    k. Falling Objects
    However, “we” do not pay for loss to:
    1) property inside a building, unless the falling object has first damaged an outside wall or the roof of the building by impact; or
    2) the object that falls.

    The ceiling fan should not just fall if installed properly so besides the above limitations of your policy, the following policy language may apply:

    b. Errors, Omissions, And Defects — “We” do not pay for loss caused by one or more of the following:
    2) a defect, a weakness, the inadequacy, a fault, or unsoundness in the:
    b) construction, … remodeling, … renovation, repair, specification, workmanship;
    c) materials used in construction, remodeling, renovation, or repair; or
    d) maintenance;
    of any property, whether in whole or in part, …

    Although unlikely, you may have a policy that differs from the policy used for reference to provide this answer. You should review your policy under the heading of “Coverage C — Personal Property” to see if the limitations outlined are actually in your policy.

  1557. July 10th, 2013 at 3:32 pm #Steve

    Dear jason,
    Update on my claim since June 8th. I received a letter today from my insurance adjuster. In it he stated that the 100K liability had been paid out to the damaged parties on a prorated basis. Please note that each party did not receive the full compensation for their damage. As a result, you may have personal exposure and it may be in your best interest to consult an attorney.

    I was not invited to the meeting of the damaged parties. I was told by one of the attendees that all parties in attendance had come to agreement on the proration. I have not been informed how much was asked for by each party. I was told that the agragate amount of claims was 123K.

    I do not understand for the life of me why my insurance did not seek any release before settlement. What is your advise?

  1558. July 10th, 2013 at 4:01 pm #Jason

    Steve,
    If the insurance company did not obtain releases for the payments they made to the other parties, any one or all of them can sue you for their shortage. Your insurance company should provide more information to you instead of just informing you that you may have excess exposure after their settlementment activity is concluded.

    There are 2 things you should do. Obtain the terms of the settlement from your insurance company, including the amounts paid and the liability claims presented to them. The liability not only is the concern of your insurance company, but to you as well. When there is a liability exposure to an insured, your insurance company must notify you in writing as soon as they are aware of your exposure, or the possibility of any exposure above your insurance limits.

    A fairly well-known case, originally CAMPBELL v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, eventually turned into State Farm Mut. Automobile Ins. Co. v. Campbell. It originated in Utah and eventually made it to the Supreme Court. Look at that case to see similarities to your case. I believe some of the early court rulings dictated each insured with liability exposure at or above their limits needed to be formally adviced of that risk as soon as that risk is known to the insurance company. The Campbell case involved bad faith (I don’t know if that applies to your case) and was in the court system for about a decade or so.

    The other would be to discuss your situation with an attorney who has experience in this area.

  1559. July 11th, 2013 at 7:59 pm #Rasheena

    Hello,
    I am a landlord and just recently purchased landlords insurance. My tenants have refused to pay rent for the past 1-1/2months and I was wondering if it is too soon to file a claim with the insurance company for lost of rent or would I be automatically dropped. I live in PA and am a new landlord. My tenants were paying and had began paying later and later in recent months and now are refusing to pay rent based on damage that they negligently caused through a kitchen fire and I have been slow to repair. My home is in a bankruptcy and I have recently been separated from my spouse and I am scared to make the wrong move at this point and loose the property because I am not able to pay the bankruptcy there and my rent here. Should I file a claim. My insurance company is Allstate. Also, I have also started eviction proceedings and have to wait another 30days before I can even get someone else to rent the property. Can you give me some advise on this.

  1560. July 11th, 2013 at 8:41 pm #Jason

    Rasheena,
    The information I post on this site is direct, accurate as humanly possible, and based on the premise of helping people with their situations.

    First, your dwelling coverage from your policy has nothing to do with your rental income if you do not receive it from your tenants. The best way to secure timely rental payments is to better screen potential tenants who pay on time.

    I understand there was a kitchen fire. Fire is a covered cause of loss under a dwelling coverage policy. You will need to repair the damage in a timely manner or excuse your tenants from the lease so they can move to a place that doesn’t have a fire-burned kitchen.

    Somehow, you are talking about your tenants and the fire damage in their unit – then you are talking about your home that is part of your bankruptcy (which I take you meant foreclosure). This is rather confusing.

    But then you say you are paying rent so you must be talking about foreclosure of the rental property.

    No, you should not file a claim because you don’t have a claim to file – at least not from the information you posted. Failure of tenants to pay rent is not something insurance covers.

    The advise is to get out of the landlord business as soon as you can. Other advice is to check the BEST AND WORST INSURANCE COMPANIES at the top of this page so you can see where your current insurance company ranks – which is not good.

  1561. July 20th, 2013 at 3:18 pm #John

    We recently had a Hail storm come through our area. After hearing that several homes in the area had roof damage, I contacted my insurance to discuss the issue. I couldn’t see any damage, but felt it should be checked. My insurance company sent out an adjuster.

    My roof, which was only 18 months old, was totaled by the adjuster.

    I contacted my roofer (The same one that installed the current roof). He inspected the roof and advised that there isn’t any damage. The roof he installed has a 50 year warranty. This roofer is has been in business for many, many years and is extremely reputable.

    Now what do I do? My insurance company has completed the claim and sent me a check.

  1562. July 20th, 2013 at 4:39 pm #andy

    I had recent storm damage and was told I will be given $3200 for repairs to my garage. What if I can get the work done cheaper and/or only do the repairs that are necessary? Am I obligated to spend all the money or tell them I have found a way to do it cheaper and refund them the difference? I have The Hartford.

  1563. July 22nd, 2013 at 7:41 am #Jason

    andy,
    Do the repairs as you see fit, and don’t be concerned about returning any left-over funds.

  1564. July 22nd, 2013 at 7:59 am #Jason

    John,
    Although your roof does not appear damaged, it is. It may last for many years but it will experience a declined in its overall longevity.

    You roof suffered a loss and the best way to handle the roof is to replace it only when you believe it should be replaced, even if that is a couple decades from now.

    With the insurance money you were sent, that is money you should set aside for when your roof will eventually require replacement. Be aware that if you encounter another loss to your roof, any damage will not be paid because you have already been paid for a complete roof replacement.

  1565. July 22nd, 2013 at 12:35 pm #Nicholas

    Dear Jason:
    My family has a fire damaged house in MA. they have a buyer for it. they have a public adjuster still working with the insurance company. an initial offer has already been made by insurance company, and subsequent negotiations are still being worked out verbally between PA and IA. but they are pretty much in agreement for the most part, except the calculation of rental loss(they had an rental unit attached) and some minor items.

    the question is if my family close the deal with the buyer and transfer title(the buyer is in a hurry to build so they can finish before it is winter, and my family wants to get rid of a property that has given them a lot of emotional stress, it has been 4 months since the fire, they are actually borrowing some money to pay off the mortgage), will this in anyway affect the insurance settlement. the closing attorney and public adjuster all seem to say no, but cannot give 100% certain answer. common sense dictates the insurance will still pay out any amount to the owner of the fire, not to the new owner, right, even after title transfers? and if the insurance learnt that they have sold, they cannot renege on whatever has been offered verbally between the adjusters? and they can still negotiate with them if they are not happy with the settlement being offered later on?

    thank you
    Nick

  1566. July 22nd, 2013 at 1:04 pm #Jason

    Nicholas,
    The insurance company has a duty to reimburse the home owner for damage sustained during the policy coverage term. If the damage is not being repaired and the house sold in its post-loss condition, then the insurance has an obligation to pay to the owner only ACV, and not replacement, value.

    For example, if the fire damage replacement value is $75,000 and the ACV value is $40,000, the most that would be paid for the property damage not being fixed would be $40,000.

    By introducing and merging another contract (purchase contract) to your insurance contract, everybody needs to know what is made part of, or excluded from, the overall purchase agreement – everything should be in writing.

    Sure, the buyers are in a hurry so they can get the repairs completed by winter but your goal is to make sure the house is sold on the conditions and terms that most benefit you.

    Insurance benefits, such as the recoverable depreciation, in the above example of $35,000 (if available) could be worked out in all the paperwork and the negotiations but to do that right would likely require the involvement of an attorney. Also, the purchasers would then be partly bound by the language of your policy. In a sense, you could sell your settlement options to which you are entitled. Keeping a purchase contract as simple as possible means less room for error, misunderstanding, and dispute.

    Remember, neither the buyers nor the realty agent have your best interest in mind, only their own. You are the only one that can watch out for your best interests. Verbal promises, assumptions, and rushing into this need to be avoided.

    A good thing would be to run all this past your insurance adjuster to make sure they understand the process of what you’re doing so you know what the insurance will do depending on the timing of the transfer, whether its pre- or post-closing.

    In the end, although you can make it work, it would be best to finalize the insurance claim, then proceed to the purchase details. Cash in hand from the insurance should give you assurance that the insurance end is completed.

  1567. July 23rd, 2013 at 9:33 am #Jen

    We had wind and lighting damage at our house in Indiana. The agent who came out and took pictures said we could replace everything damaged, but we had to pay for them out of pocket then get reimbursed. I have never in my life heard of such a thing. I am also terrified to do this because if they decide to not cover the cost we are stuck. This also puts us out months without stuff because we do not have the means to go replace everything lost. I thought when we had total replacement that they would write us a check for the average cost to replace each item. Also each time I talk to the adjuster, he tells me something different. It just doesn’t add up. Quick response would be great. The lighting knocked out almost every appliance and we need them.

  1568. July 23rd, 2013 at 10:00 am #Jason

    Jen,
    The standard procedure for storm damage is for your insurance company to pay you the ACV of the damage for both your personal property and damage to the structure.

    For example, if you have a t.v. that is damaged and it’s about 3 years old and replacement cost is $600, they should send you an ACV payment of $400 so you can replace it. Then with the receipt for its replacement, you would make a secondary claim for the $200, or what is commonly referred to as recoverable depreciation.

    Another example: If your siding replacement damage is $2500, then they should pay you an ACV value of, let’s say of 70%, or $1750. A secondary claim would be needed to collect the recoverable depreciation.

    Regardless, the communication you have with your insurance company adjuster should give you enough assurance of what the amounts you can expect for your initial payment and any additional future payments.

    There is a time limitation for replacement claims made for recoverable depreciation and it may by 6 months or 1 year. Check with your insurance adjuster to determine what time limitations apply to your claim.

    In the mean time, you may have to spend out of pocket money to replace, for example, a refrigerator immediately if a repair is not reasonable and that applicance is necessary for you to continue living in your home.

  1569. July 26th, 2013 at 10:11 am #Pablo Beltran

    I got a check from state farm claim adjuster to repair my roof from wind damage. I had a roofing company come look at it and they said i needed to re-roof cuz i was going to keep having trouble with that old shingle.The claim adjuster is going to come have a second look and have a talk to the roofer for more info i gueess.If i cash that check that i received for repairs, will that affect me from getting the money to re-roof my house?

  1570. July 26th, 2013 at 10:15 am #Jason

    Pablo,
    If your claim is not yet fully completed, hold onto that check until the entirety of your claim is understood and the full value of the damage is confirmed.

    It likely won’t affect an additional amount being added to your claim total, but since your claim is still being investigated, it would be best to hold onto the check without cashing it right now.

  1571. August 6th, 2013 at 11:01 am #Michael

    Hi just wondering, I had a fire at my house this week and I was wondering if the insurance company would still pay if my insurance payment is tied in with my mortgage payment and my mortgage is behind. Thank you for your help.

  1572. August 6th, 2013 at 11:09 am #Helen Zeeus

    I own a home in Alabama and live in Florida. I am renting the home out in Alabama and need homeowners insurance. The insurance I have in Florida will not cover Alabama and the company does not rent out of state insurance. Where can I can insurance to cover the Alabama home?

  1573. August 6th, 2013 at 1:04 pm #Jason

    Michael,
    With your escrow account, you pay monthly into that fund for insurance and once or twice per year, the premium for your insurance is paid through that fund. If you are behind in your payments, the bank should force coverage onto the property for their protection, and they charge you for that forced insurance. The bank’s insurance is rather steep and it may only protect the bank – not you. It all depends on the insurance they may have. However, you may still have coverage under your insurance if you are not too far behind in your payments.

  1574. August 6th, 2013 at 1:06 pm #Jason

    Helen,
    Find an independent insurance agent in Alabama and let him know you need a dwelling policy for that rental property. It should be as easy as making a few phone calls.

  1575. August 7th, 2013 at 10:02 am #SH

    We have an estimate from the contractor whose line items do not match the line items of the estimate from the insurance company. The contractor included things such as storage from our furniture while the hardwoods were refinished, among other things. Ultimately, the total dollar amounts from both of the estimates were fairly close. However, we contacted the insurance company and made them aware of the discrepancies of missing line items in their estimate and requested that we be reimbursed for those things (ie storage, etc). We were then told that since the totals were similar that they would not cover those additional line items. Our question is: Are they not obligated to reimburse us for the covered line items that were not listed in their estimates because the grand totals of the insurance check was similar to the grand total of the contractors estimate? And were were also curious as to how the contractor had been able to communicate with our insurance company without our knowledge if we (not the insurance company) had hired him? Thank you for your time and assistance with our matter.

  1576. August 7th, 2013 at 11:19 am #Jason

    SH,
    On the insurance estimate, there should have been an allowance for contents manipulation. Removing furniture from the work space and then replacing the furniture when the work is complete.

    With your situation, it’s very likely the insurance company would ask the contractor to work from the insurance company estimate. That would then be called an agreed repair price.

    It is likely your contractor was not in communication with your insurance company. Estimates, for the most part, are going to arrive as approximately the same amount regardless who writes it – especially if all costs, expenses, and concerns are the same for what the estimate details.

  1577. August 7th, 2013 at 12:22 pm #SH

    Jason,

    Thank you for the quick response. The work was “completed” (not to our satisfaction) several weeks ago. The contractor had not spoken to us since then and we learned yesterday (from him) that he had emailed a copy of his estimate to the insurance company. While there is a “contents manipulation charge” in both estimates we were also charged for “storage” by the contractor for approx 4weeks since the furnishings had to be out of the home during the repairs. our concern is that even thought the final amounts are the same. there is approx $3500 worth of charges from the contractor for things that were not listed by the independent insurance adjuster. Now, we are being told by the insurance since they see that the total from the contractor was close to the total that the adjuster came up with then they do not need to pay us for the items that they did not list on their initial assessment, whether they are covered or not. Is this legal? The other question is we never had an initial estimate from the contractor because he said the we did not need one since his charges would wind up being close to what our insurance would pay out. The estimate was givne to us after the work was finished. Is this normal?

    Thank you again.

  1578. August 7th, 2013 at 5:19 pm #Beth

    My parents had a claim at their cabiin and we have a recorded message from the insurance company that it was a valid claim, they were cutting the check and it was in the mail and they took $1000 deductable. The repairs had begun and a week later they called and said they were not covering the claim. In this time the cabin was put on blocks and base of cabin was taken off, electricity and plumbing disconnected. We contacted the CEO who turned it over to their lawyer. They offered $10,000 but the claim is more than $50,000 and since this has been such a lenghty process, it now has more damage. What recourse do they have?

    Thanks,
    Beth

  1579. August 7th, 2013 at 6:40 pm #Pat L.

    I have a few questions in regard to our property/homeowners insurance claim – specifically a “fire event” – that took place in 2011 at an adjoining neighboring property, and our Insurance company, State Farm has refused to settle the claim, make full payment or deny the claim.

    Our property sustained fire/smoke/water damage on the south side of the property which abuts the neighbor’s property and primarily water and smoke damage to the entire residence as a consequence of this “fire event.”. The neighbor’s property remains uninhabitable, blighted and abandoned – to this day. This property was put for sale property in Spring 2012, purchased by a developer, but remains in a damaged state.

    We contacted our State Farm Insurance agent later that afternoon. She arrived in the late afternoon, reviewed the situation and advised us to subrogate this claim with our insurance company, State Farm. We immediately addressed the necessities and pressing demands of the fire event, subsequent damage, recalcitrant neighbors and changing property owners.

    Two weeks later the SF Adjuster,inspected the property in 3 weeks later, accompanied by a SF’s preferred provider to assess the damage. In essence, the adjuster foisted his services upon us.Not only did the PSP conduct an incomplete inspection, his crew (mis) repaired the plumbing repair that needed immediate repair and only exasperated the damage. By way of example, he had one sub-contractor estimate the job ( after we noted it was missing) without even seeing the site. His resulting overall damage/repair estimate substantially undervalued the property damage / repair and was incomplete in its scope. This is relative to other subsequent estimates we have received.
    State Farm’s communication were/are mis-leading and somewhat conflicting and confusing in their advice. In the interim period , they have also (somewhat) changed adjusters.

    During the course of the first month, we became alarmed with the behavior of the SF adjuster, their preferred providers + process of State Farm – which appeared to test legal boundaries and, certainly, not advance our needs as claimants.

    Due to the decrepit, fetid, condition of building next door we needed to move. Despite our requests to State Farm for information, we remained relatively unaware of the claims process involved in regard to the more nuanced line items that are specific to ALE, property damage and building contents. Also, we were advised to wait until the neighbor made their repairs to do ours. Otherwise we would need to do our repairs twice. SF advised us that they would pay only once for the repairs and to wait for the neighbor to complete their repair.

    We hosted an ongoing parade of SF “people” agent/ adjuster/ investigators/ various PSP’s all to inspect the property a number of times – probably 10 inspections within the first moth or two of the fire event. Hundreds of photographs were taken by SF, etc. and submitted to their files.

    A month or so following the fire event , a member of their Special Investigative Unit called and wanted to interview me about the fire event and to record the conversation. I reluctantly agreed and required a digital audio copy of the conversation. It was only after numerous requests and 6-7 months later that I received a transcript.

    In Feb., 2012, SF made one partial payment of one month’s mortgage + some monies for repair in 02/12. This was based on their PSP undervalued and inadequate estimate.

    The adjuster then failed to communicate ( other than robo-script letters) – stating they were was sick. A new adjuster took over ( after numerous email/letters from me) in fall, 2012. He, too, has been basically MIA – with the local agent acting as his apologist.

    We submitted more claim ( very detailed inventory sheets ) as well as very detailed and professional estimates, receipts, et all. They denied received the claims for over a month – despite the fact that the local SF agent sent them to him 3 times and I sent them in myself 2 times (!)

    Now the adjuster and his manager want to re-inspect the property – almost 2 years after the fact – as thy state that there some discrepancies between the original adjuster’s notes and what we submitted . We have repeatedly asked them for specifics of their concerns – for four months now -and they refuse to give us any specifics nor any written questions for us to answer.

    I recently filed a complaint with the state’s Dept. of Insurance. Consequently, the SF manager called my out of the blue to talk to me about the complaint. I spoke with him and he truly did not discuss the complaint. He only kept asked how we arrived at the decision to replace the damaged, broken or missing items….and wanted to come by again to re-inspect the premises. I , again, asked for specifics , and he had none. Further, he demonstrated a remarkable degree of unfamiliarity with the claim.

    When pressed repeatedly, he said he needed to reinspect the water levels in the garage . When I queried him as to how he could arrive at any kind of accurate determination on a concrete foundation that was well over 100 years old, he had no answer = ????

    We can only speculate what is going on here – and, I’m sorry to say that it lives up to every element of bad faith and delay tactics that we have heard of. We are hoping you might have some insight as to what may be motivating this ( or is it simply wanting not to pay the claim or pay a miniscule amount.)

    Thanks so very much for your consideration and patience in reading thru this!

  1580. August 7th, 2013 at 7:53 pm #Jason

    SH,
    Your arrangement and deals with your contractor is a contract between you and your contractor. As for providing estimates, contractors do many things their way.

    Unless I don’t understand, that $3500 is for work proposed by the contractor that is not covered by insurance? How can the estimates be so close, yet they are $3500 apart? That is not close.

  1581. August 7th, 2013 at 8:05 pm #Jason

    Pat L,
    I don’t have any input to your post.

  1582. August 9th, 2013 at 10:39 pm #EVELYN

    HELLO, I LIVE IN NEW MEXICO AND CURRENTLY MY INSURANCE AGENT IS ALLSTATE, THEY GO THROUGH NEW MEXICO PROPERTY INSURANCE FOR MY HOMEOWNERS POLICY. I HAD TROUBLE PAYING MY QUARTERLY PAYMENT ON TIME WHICH CAUSED MY POLICY TO CANCEL. ALLSTATE NOW IS REQUIRING ME TO OBTAIN A LIFE INSURANCE THROUGH THEM BEFORE THEY WILL RENEW MY HOMEOWNERS POLICY AND IF I DONT THEY WILL NOT RENEW MY POLICY. THEY ARE HAVING AN AGENT COME TO MY HOME AND HE IS WANTING TO OBTAIN URINE SAMPLES AND BLOOD SAMPLES AND OTHER ASSESSMENTS FOR THEM TO LET ME HAVE A LIFE INSURANCE THROUGH THEM WHICH THEY ARE REQUIRING I GET . IS THIS LEGAL AND HOW DO I KEEP FROM HAVING THE ADDED EXSPENSE SINCE I ALREADY HAVE A LIFE INSURANCE THROUGH MY HUSBANDS PLACE OF EMPLOYMENT. VERY TIRED OF BEING RIPPED OFF THROUGH THESE SO CALLED INSURANCE COMPANIES AND DESPERATELY NEED YOUR ADVISE. SINCERELY EVELYN PLEASE CONTACT ME ASAP. THANKS

  1583. August 10th, 2013 at 5:31 am #Jason

    Evelyn,
    Good thing you asked your questions. Allstate is rated near the top for dissatisfied customers. At the top of this page, you can see BEST AND WORST INSURANCE COMPANIES and you should look for a good company and switch your insurance as soon as possible.

    Is what they are doing illegal? Probably.

  1584. August 12th, 2013 at 4:05 pm #Gus

    Hello, I live in my home, in VA., which I transferred to my mother about 10 years ago. The homeowners policy (State Farm) is also now under my mother’s name, but she lives in FL.. The policy covers contents for about $100K.
    About two years ago, I had a theft of about $3500.00 in gold jewelry done by a couple of guests to my home. I immediately called the police, and reported the crime. They did a thorough investigation, but they never recovered anything. I co-operated with the entire investigation. I even had pictures of the jewelry from when I had them appraised. The thing is that one thing led to another, life, forgetfulness, not knowing or thinking about a claim, So weeks, months, and now a couple of years have gone by, and I never even reported anything to State Farm. Every time I think about it, I think too much time has gone by, so I never made any claim what-so-ever. I know now in hindsight, that I should have called them immediately, but the more that time went by, the more I felt it was a lost cause.
    Am I completely at a loss now?
    Is it too late to even try anything, as far as an insurance claim?
    Please let me know.
    Thank You

  1585. August 12th, 2013 at 4:24 pm #Jason

    Gus,
    I don’t know the statute of limitations in your state and that is what would bar you from having a successful claim.

    The only way you will know is if you submit a claim and see where it goes.

  1586. August 12th, 2013 at 7:36 pm #DTrigiani

    My house is 7 years old. I recently encountered that the wall cabinet the one below and the ones below the sink were bowed in the backs. There is a smell of mildew. I called my insurance company and they sent out a mitigating person to assess the damage and contact them back. They called back and they could not find any active leaks in the way. They communicated to the insurance company that they believe it is to the improper flashing (faulty contractor work). I need to know what to do as the insurance company is sending out an adjuster to view the damage. The person they sent felt they were only going to pay for the inside damage (cabinets, counter top back splash warped) and that I would be responsible for repairing the faulty work, and replacing the walls, etc in my home. Please advise and provide advice.

  1587. August 12th, 2013 at 9:29 pm #Jason

    DTrigiani,
    That scenario is likely the one that you will be under. The insurance provides for unexpected and sudden damage. If there was a water leak for a long time from faulty construction, there technically shouldn’t be coverage for that because it is not sudded. And, technically, if it’s not constructed correctly, it is also not unexpected. Because if it’s not built correctly, then it is expected to fail.

  1588. August 13th, 2013 at 2:15 am #PAM HA

    Hello,
    Needed some advice, my son and his girlfriend rent a duplex in Austin, Texas. About a week ago, my son’s girlfriend came home after a night out drinking with friends and realized she locked herself out of the house. She went to the bedroom window to knot on it to wake up my son that had come home before her. In the process of knotting on the already broken window, the window broken all the way and hurt her right wrist badly. My son drove her to the ER and they sticked it up, however she was able to move her fingers in the next few days. They went back to the ER that treated her and they said they couldn’t help because and referred her to a hand dr. It took several days before they could get in to see him. Then he told her she had nerve damage and they she would need surgery and rehad if she wants to to have use of her fingers. The problem is the surgery, dr and rehav is very expensive and she had no insurance and time is an issue. She was sent to several agencies to try to get help, so far she is either no poor enough or the waiting list is several weeks long and there are no sure thing she will qualify. I was trying to see if I could think of something to help. I was thinking about my own insurance I have on my home if someone gets hurt on my property. So shouldn’t the property of the duplex have insurance coverage? If so would it cover something like her issue? Could she make a claim, even if she was under the influence of drinking? and even if they may have not reported the window to have been broken. ( I don’t know if they had reported to the owner) Would she have the right to make a claim and how would she go about it? Not to sue, but to get her hand taken care of. Any help to some of my questions would be great. Thanks

  1589. August 13th, 2013 at 6:59 am #Jason

    Pam,
    There may be a little bit of coverage for medical payments for people hurt on the owner’s property. Usually this limit is rather low and not every owner carries this insurance.

    It could be determined only after your daughter makes a claim. Her condition during the injury has nothing to do with any available medical coverage because it is not based on negligence or liability – just that someone was injured on the property.

  1590. August 13th, 2013 at 8:55 am #jeremy

    so my house burnt down the insurance cut a check how was not able to pay on the loan so the house foreclosed the bank to the property and there is about 20,000 dollars left over should that money come to me? if so how do I go about getting that money

  1591. August 13th, 2013 at 3:44 pm #Debbie

    My niece received a car from parents for graduation but didn’t want to drive it till school started so they hadn’t insured it yet. It was stolen from her property can she claim it on her homeowners policy? thank you!!!

  1592. August 14th, 2013 at 9:17 am #EVELYN

    THANK YOU SO MUCH JASON, I WILL TAKE YOUR ADVISE AND I WILL IMMEDIATELY SWITCH COMPANIES. I DIDNT THINK THEY COULD REQUIRE INVASIVE PROCEEDURES ON THEIR CUSTOMERS. SINCERELY EVELYN

  1593. August 16th, 2013 at 6:32 am #Brenda

    We have flood damage and the mortgage company is holding our insurance check….can we do the repairs our self… which we have started to do and have done… why would we need a contractor when we can do the repairs ourself.

  1594. August 16th, 2013 at 4:39 pm #Jason

    Debbie,
    Some insurance policies include coverage for newly acquired vehicles. Some insurance companies provide for 14 days before the car has to be reported. That is the only hope. A homeowner policy specifically excludes coverage for cars.

  1595. August 16th, 2013 at 5:38 pm #Jason

    Brenda,
    Yes, if you are qualified and capable of doing the repairs, you can do the repairs yourself.

  1596. August 19th, 2013 at 12:38 pm #Alex

    Dear Jason,

    I have an HO3 policy in Florida, and a galvanized steel plumbing pipe burst in my concrete slab.

    The insurance company sent a water remediation guy to my house today. I just received a call from the insurance company asking me to send them estimates on all the repairs that are required. I thought this was the job for a public adjuster. They said they don’t feel the public adjuster is necessary.

    Should I go ahead and send the insurance company estimates, or should I demand that they send a public adjuster? Can I even make that demand? I am concerned that they are trying to eliminate potential claims by only asking for estimates from me.

  1597. August 19th, 2013 at 12:52 pm #Alex

    Excuse me- in my comment above, I referred to “public adjuster.” I meant any insurance adjuster.
    Thanks,
    Alex

  1598. August 19th, 2013 at 1:04 pm #Jason

    Alex,
    The insurance company is probably trying to settle your claim using a deck adjuster by getting an estimate from you, justifying that it is reasonable, you suffered a covered loss, and then paying it. It seems to be a shortcut to settling smaller claims where coverage is not an issue.

    As for adjusters, a public adjuster is one that is hired by the people who have insurance and have damage to their home. The public adjuster works for the policy holder and tries to maximize the monetary payout of a claim. Besides working for the policy holder, these public adjusters work for themselves too. They get paid a percentage of your claim – between 25-40%. I’ve even seen some cased of the percentage being 50% of the claim payout.

    What is ideal is to have an independent adjuster come out to record your damage and submit an estimate. An independent adjuster streamlines the claim from the policy holder to the insurance company with a recommendation of how much to pay. They also provide an estimate of the damage. These independent adjusters work for themselves but are paid a fee by the insurance company for their services.

    With a claim, the policy holder has to prove to the insurance company that they suffered a covered loss and how much that loss was. But many times independent adjusters are used for that purpose.

    The other kind of adjuster is one that is paid a salary by in insurance company to inspect and settle claims. This would be considered a field claim adjuster.

    It’s probably ok to insist that the insurance company send an independent adjuster or a field adjuster to document your damage and report it to the insurance company.

    If you submit them an estimate above their allowed authority to settle the claim from behind the desk, they will either get an independent adjuster or a field adjuster to inspect your loss.

    It may be wise to get a contractor to inspect your damage and provide an estimate for the damage. You probably have to get a contractor no matter what anyway, right?

  1599. August 19th, 2013 at 6:46 pm #Randy

    I have suffered a home fire, My question is this, I have heard that the insurance company has to pay out 100% if the structural damage goes over 80%. Can You tell Me if this is true or not. I live in Ohio and my insurance company is State Farm.

    Thanks Randy

  1600. August 20th, 2013 at 7:17 am #Jason

    Randy,
    Ohio is a valued policy law state. That means if your house damage to the extent it is considered a total loss, the insurance company pays you the policy limit for that loss. The threshold for a total loss may be higher or lower than 80%, but 80% is a reasonable threshold to determine if the home is totaled or not.

    There are conditions to the valued policy laws like being the primary lived in home by the insured owner. For example, if you own a home and it’s rented to a family and burns down, the valued policy law does not apply.

    You can look up valued policy laws in Ohio for more information.

  1601. August 20th, 2013 at 1:11 pm #Misty

    Hello. I live in TX and recently had a rotting/sick tree fall on my vehicle as well as my neighbors vehicle. My vehicle was totaled needless to say. We lease the place we currently reside. We contacted the management (who was aware of this pending issue but failed to do anything about it) prior to the actually incident.

    A claim was filed with the HO’s insurance carrier. The 1st 2 times, the claim was filed incorrectly so this delayed the process about 3 weeks. During the 3rd week, we finally got the correct adjuster. After just a few days, the adjuster assigned told me that her recommendation to the insurance agency would be to pay the claim.

    Since that time, we have waited another month to finally get word that the claim was denied and that we should be receiving denial letters in the mail soon. This news came yesterday and the incident happened on June 30 2013. What can I do about this denial? The HO’s management team was notified about this potential hazard a year prior to the incident and did nothing to protect us, their tenants.

  1602. August 20th, 2013 at 2:16 pm #Alex

    Jason,

    Thank you very much for your informative response. You are truly a gentleman, and your website here is one of a kind. I appreciate your service to the community.

    Alex

  1603. August 20th, 2013 at 3:00 pm #Debbie

    Dear Jason,

    Thank you for responding to my question. Thank the Lord the car was found a couple of blocks away from my nieces house with no damage. I guess someone just needed to get somewhere and didn’t want to walk.
    Your website is very informative. It’s interesting! Have a great day
    Debbie from California

  1604. August 20th, 2013 at 4:02 pm #Jason

    Misty,
    Your situation is unique in that it is a perfect example why you don’t want to put yourself in a position to rely on the outcome of insurance carried by another person.

    The solution is simple. The property owner was aware of the rotting tree and that it was a matter of time before the tree limb fell down. The owner knew about this dangerous situation because you, and others, informed the owner.

    Well, you cannot forget that your act of informing the owner of the property that the limb was a danger was also the act of you confirming your awareness of the dangerous limb and that its fall was certain.

    For you to park your car under a knowingly dangerous tree limb puts the responsibility of the damage on you. People need to protect their property and for you to park your car under a tree limb that is rotting, you’ve willingly accepted the nearly certain result of property damage.

    File your claim of car damage with your insurance company if you have physical damage coverage and leave the property owner alone.

  1605. August 20th, 2013 at 4:49 pm #Randy

    Thank You for quick response, You have been very helpful.

  1606. August 21st, 2013 at 11:34 pm #Candice

    Hi,

    I live in Georgia and have Allstate. The adjuster denied our claim yesterday for water damage and mold created by a clogged washer drain. He said it was due to leakage/seepage over a period of time (he was not specific on length he was using).

    Our issue is that we had no way of knowing there was any problem because it was hidden in the wall. When we noticed a wet spot on our ceiling last week, we called a plumber same-day, identified source and filed our claim without delay. We had never seen any evidence prior. If it did occur over a longer period (again, we don’t know the timeframe they use for limitation), it didn’t show up in a visible area until last week. The location of the wet spot is not directly underneath the source (our washer is on the second floor and wet spot showed on in a corner of kitchen ceiling, somewhat diagonal from source above). It also took the adjuster a week before he visited our home.

    We are sick with worry over this cost. I can’t sleep thinking about how this will affect my family. We purchased extra mold coverage with our policy when we bought our home a few years ago at the advice of our agent and it doesn’t seem worth it now. Is there anything we can do? Thanks for your time in reading this.

  1607. August 22nd, 2013 at 7:50 pm #Jason

    Candice,
    Switch to a company that has a better reputation with people who have claims denied or have bad claim experiences. At the top of this page, there is a link to the BEST AND WORST INSURANCE COMPANIES. You may want to go visit that site so you can become fully aware that your current company has a reputation for being ranked at the top of the list for bad claim experiences.

  1608. August 28th, 2013 at 2:10 pm #Julie

    I lost everything in my home to a house fire last year, including my two dogs. The foundation was salvageable, but everything else was lost. Is there any reason why I should not receive the full policy payment? I have a replacement cost policy and my dwelling was insured for $500,000, but it was determined that it was $350,000 to rebuild it so that’s all I got. They now want me to accept a lump sum payment for contents that will result in me getting a settlement that is about 70% of my policy limits.

  1609. August 29th, 2013 at 1:09 pm #AJ

    Hi! I had a quick question. You covered loss, and what happens when you don’t spend the full amount.

    We had water damage, and they wrote us a check. We think with all of the repairs we will do right now, and the ability to do some of it ourselves, there may be money left over. If they asked us to save and submit receipts, does that mean they can ask for the left-over money that isn’t accounted for once the repairs are done?

  1610. August 29th, 2013 at 8:15 pm #Jason

    AJ,
    If you do some of the work, you should be adequately reimbursed or paid for your time and effort. Or if you did the work for less than the typical costs allowed for that work, then you used the funds wisely. No, your insurance company will not ask for you to send any money back.

  1611. August 30th, 2013 at 10:08 am #Ryan

    Last week in my condo the water heater went bad and sprung a leak. The water heater is in a closet in the bedroom and the water ruined the carpeting in both bedrooms the hallway and the flooring in the bathroom. When the adjuster came out he also put on his assessment costs for drying out the living room carpet and also over priced a couple of the other rooms. After all is said and done I think the check they sent me according to the adjusters assessment will be a couple hundred dollars over the actual costs. Am I obligated to pay this money back to the insurance company?

  1612. August 30th, 2013 at 12:38 pm #Jason

    Ryan,
    No.

  1613. September 3rd, 2013 at 10:40 am #Carly

    We had a huge leak in our master bathroom the water leaked down through the family room ceiling, contaminated the entire master bedroom and walk in closet. They came out, our master bath is tiled 5 feet up on all walls and the floor is tiled on a mud floor. they pulled out the walls in the master bedroom and family room and the walk in closet, they pulled up the carpet in the master bedroom, they did not do any testing under the tile floor or walls and told me, “lets just hope it is not there because that would be huge. There was a horrific smell that did nto go away even with teh insulation and carpeting and sheetrock removed a fungicide applied and their intense fans and dehumidifiers running. They gave us a statement of loss and we faxed in the notarized signature. The next night I dropped something in the bathroom and I saw that the tile floor is buckling and has a crack and the wood moulding around 2 of the doors is filled with mold that was not there before and behind the toilet where it leaked there is a horrid stench of mold and it is starting to grow on the tile and under the sink that they did not check even though the plumbing leaks were not determined because we pay that they did not check the vanity is completely destroyed. I just called them and let them know someone needs to come out due to the water situation that is the same claim and felt they did not do the job in investigating the leak in the tile, now they are playing hardball and saying that it needs to be a new claim with $2500 deductible when it is clearly the same claim. I made a fuss and finally called the office, it is a small company with one office in NY and they said they would send the adjuster and the remediation team to look at it and then the guy started doing some very tricky moves like saying there is no way the sink and toilet were on the same claim and they did me a favor and that I should be grateful etc. Then I explained the leak all happened when they were here it is the same claim because there were plumbing line issues that supplied the water. He did not want to listen but said he would send them out Thursday. A couple of questions, what is the best way to deal with this, I told him since their was a mud floor and tile all around naturally it was going to take a few days longer to show and that they should have checked, I also said they never checked the under sink damage of the vanity. Can they now deny our original claim or hold that over our heads if we pursue this? WE cannot use our Master bedroom or bath the smell is unreal and the mold keeps growing.

  1614. September 3rd, 2013 at 10:57 am #Jason

    Carly,
    When you say “they” came out. I would assume you mean a remediation company that deals with water damage. This seems to be all related to your original damage, and the remediation, drying, and repairs were not adequately completed.

    This partially falls on you. You, as the homeowner, need to bring in a trusted repairer chosen by you and who will do the entire job – not just some of it and hope for the best.

    Make sure your insurance company understands this is one loss and the contractor that did the drying and repairs did not address all the damage. If you don’t seem like you are getting anywhere, talk to the claims manager. Or if that doesn’t work, his manager. Stay on this until you get the end result you need.

    You can have several different contractors come in to give you their opinion about what needs to be done. When parts of a home get wet and not completely dried, there will be mold and odor problems. These problems can escalate to the point your home is completely uninhabitable. Don’t let it get that far.

    Regardless if you have the backing of the insurance company at this moment, you have to remove the wet items from your house because you have the obligation to protect your home from further damage. Further damage is occuring at this moment.

  1615. September 3rd, 2013 at 11:23 am #Choka

    I had a break in and the items taken were gifts and the adjuster has spoken to the gift givers and I have given the insurance company the manuals and serial numbers but they are still trying to get receipts. I want this claim closed so that I can replace the items. Am I under any further obligation to find receipts for gifts?

  1616. September 3rd, 2013 at 12:04 pm #Carly

    Jason,

    The remeidiation team was called by our insurance company and we were not even told we had a choice, they came in, the insurance company said they would pay them and that was it. They also sent us the proof of loss for the replacement of the sheetrock, insulation, carpet, paint etc.

  1617. September 3rd, 2013 at 12:25 pm #Carly

    Hi Jason,

    The insurance company sent in their own remediation team they said this is the way it was done and they would pay them direct and wanted it done as quickly as possible. We did not know that there was any other way.

  1618. September 3rd, 2013 at 1:14 pm #paul

    my son had a party at the house and some items we stolen should i file a claim and if so how do i go about it intelligently

  1619. September 3rd, 2013 at 2:32 pm #Jason

    Carly,
    I don’t like the arrangement that the insurance company brings in the restoration company and kind of forces them onto you for the work.

    Now that you know, get a restoration company you know and trust and have them do the work correctly this time. Ask questions. The adjuster should have told you that it’s your home and only you, as the homeowner, can hire the people that work it. Sure the insurance pays for the restoration and repairs but their role should not extend to the insurance company bringing in their company to do the repairs.

    The repairs are a separate and distinct agreement between the you and the restoration company. Now that your insurance company has entered that relationship by bringing in the contractor, they are exposing themselves to whatever that contractor does wrong. This isn’t a contractor/homeowner issue – now it’s a homeowner/insurance company/contractor issue.

    Don’t believe everything your insurance company tells you, expecially if it doesn’t seem right.

    You are back to square one on your claim so the best thing you can do is find a contractor you can trust and who will restore your home after getting all the wet compoents out. Contact this adjuster’s claim manager and let him know what happened and how your were led to believe you were not allowed to bring in a contractor you trust.

    The relationship between the restoration company and the adjuster seems too close and with close relationships, they are watching out for their own interests – not yours. Your interests need to come before theirs.

  1620. September 3rd, 2013 at 2:41 pm #Jason

    Choka,
    Gifts generally don’t come with receipts. If your insurance company adjuster has spoken with the gift givers, that is all they should need. If you believe the demands are too much for your claim, talk to this person’s claim manager and get his assistance so your claim can be settled.

  1621. September 3rd, 2013 at 2:49 pm #Jason

    paul,
    It’s entirely up to you to file a claim for property stolen from you.

    File a police report for the items that were stolen. A police report will need to be filed for your claim to be fully processed.

  1622. September 3rd, 2013 at 8:07 pm #Carly

    Hi Jason,

    I did talk to the highest up in the claims department and he was the one that would send then remediation company and the adjuster to look. But now I know they are all in each other’s back pockets. We were not even given an option of bringing in anyone else. I don’t know what to do now. They are a small company and as I said I spoke to the head of the claims department and he was rude and trying to tell me that they have no fault and that this is a separate claim, the adjuster even wanted to say that it was continued seepage even though we had all water turned off since the beginning.

    They are lying and now they are all going to all cover each other and say everything that benefits the company. Apparently they have a thing going with this remediation company and so neither is going to say anything against the other. I am sick to my stomach, I am at a loss of what to do and they are coming out Thursday.

  1623. September 6th, 2013 at 7:35 am #Paula

    Hello:

    client suffered water damage loss 3 years ago, was paid for damages accordingly. Insured currently is remodeling and has now discovered extensive mold damage within walls.

    Insurance company is denying claim as their stating MA Law limitation of 3 years.

    Can you review and advise.

    Thank you.

  1624. September 6th, 2013 at 8:33 am #Jason

    Paula,
    Statute of limitations in the state take precedent and the denial is proper.

  1625. September 6th, 2013 at 12:51 pm #Christian

    Jason,

    I recently had my garage broken into and a very expensive bike stolen (among other items). The replacement value is about $4000. I have replacement value insurance but I was only paid an ACV of $2000, with $2000 being placed in recoverable depreciation.

    I was told that I can submit receipts for the items after purchased to recover the depreciated value. However, in the case of the bicycle, I don’t plan to replace it with another $4000 bike, as my biking desires have changed, but I feel like the ACV given to me was very low compared to the value of the bike and my loss, I could have sold it for more then I was paid.

    It is illegal/unethical to purchase a $4000 bike, submit for reimbursment of the depreciated value, then return or sell the bike? I wish they had simply paid me what my policy was for then I wouldn’t be made to feel icky and sneaky.

    Thank you.

  1626. September 6th, 2013 at 1:29 pm #Tami

    We had a small building burn down. Insurance adjust. was out and issued a check for both of us and the bank. This was a building we moved in after we got the loan. At this point are not going to replace the building. Will the bank sign off on this and turn the money over to us, or will be have to put in on our house loan? No one is at the bank till next week that can answer our question.

  1627. September 6th, 2013 at 2:07 pm #Jason

    Christian,
    Because your bike was stolen, you only have the option of taking the $2000 for it or buying a new bike and then collecting the other $2000. That way, you would be restored back the your position before the bike was stolen. You could ask for more ACV relating to the bike but there is no guarantee the adjuster would do that.

    If you purchase the bike for the sole reason of getting the $2000 and then sell the bike that would be unethical and likely illegal.

    However, if you purchase the bike and get the recoverable depreciation and eventually sell the bike because your interests have changed, then that would probably be ok.

    Do you notice how both situations seem almost identical that I just described?

  1628. September 6th, 2013 at 4:00 pm #Jason

    Tami,
    Your question is about your mortgage company/bank. It isn’t related to insurance.

    You’re going to have to wait to ask your bank.

  1629. September 9th, 2013 at 10:59 am #Chris

    Hi (again!)

    I had posted a question back in May, 2013 ( May 11th, 2013 at 11:14 pm is my original post) regarding a claim from Feb, 2013.

    Just to recap, the water heater in my my rental condo in Las Vegas leaked below to the condo under mine. It caused around $7500 in damages to her condo below.

    I did not have insurance on my condo, so her insurance agency expected me to pay for all her damages.

    So, I hadn’t received any additional notices from her insurance company regarding payment. The last contact was an email that they sent containing PDF files with pictures and damage costs…. Which I didn’t respond to.

    Now, I just received a letter from a company called National Commericial Services, Inc., who basically was hired by her insurance company to get the money from me.

    The letter is titled “Formal Notice For Response.”

    It says: This office has been retained by the above referenced client to resolve an outstanding balance due. This subrogation matter pertains to a financial loss suffered by our client on the above stated ‘Date of Loss’ and is your obligation.

    This letter is a courtesy, requesting that you either pay the balance in full or contact this office immediately to render your version of the incident in question. In order to avoid further action, please contact this office in ten days of the date of this letter to discuss your obligation, remit payment in full, or make payment arrangements.

    Sooooooo, honestly, what would you recommend? Should I hire an attorney, or is that a waste of money?

    Again, I really value your opinion, and I realize that you’re just giving the best advice you can, but any help you give is MUCH appreciated.

    Thank you again,
    Chris

  1630. September 9th, 2013 at 1:47 pm #Jason

    Chris,
    Who cares if the water originated from your unit that caused the lower unit’s damage. If you were not negligent in the water leak or overflow, you have no obligation to pay for the lower unit’s damage. I don’t know all the specifics of the incident but just because the water originated from your unit does not make you negligent or liable.

    In order to collect any money from you, the insurance company would have to sue you and absent any negligence on your part, they likely will not be successful with that action. (Nothing in this post is legal advice and should not be taken as legal advice.)

    I can’t tell you what to do in regard to an attorney; however, if it was me, I would ignore the letters. If you want the letters to stop, you will have to write to the collection agency that sent you the letter and demand that they stop contacting you in any fashion.

  1631. September 9th, 2013 at 8:09 pm #Chris

    Hi Jason,

    Thank you very much! I really appreciate your time and advice!!

    I’ll keep ya posted 😉

    Thanks again,
    Chris

  1632. September 9th, 2013 at 8:23 pm #Jason

    Don’t wait until you have a claim to find out that you are with the wrong insurance company. A good rule of thumb is to compare insurance companies every 3 years to see if you are with a good company and to see if you have all your insurance needs met. A nice area to check is THE BEST AND WORST RATED INSURANCE COMPANIES at the top of this page. Find out if you are with a good rated insurance company or a not so good rated insurance company. See what other people are saying about their claim experiences because that is kind of important when you experience a claim.

    There is nothing like having a smooth claim experience. Those that have nightmares involving their insurance company become very frustrated, and for very good reason. Take the time right now to find an independent agent and a good insurance company so your potential future claim experience is a good one.

  1633. September 30th, 2013 at 4:45 am #Pyar

    Dear Jason,
    We had a fire that began on the second floor of a 3 story 1885 building with balloon construction. There was extensive smoke damage to the second and third floors. The insurance company agreed with the contractor that the 2nd and 3rd floors needed to be gutted to get rid of the smoke smell. The interior had recently been painted and was in excellent condition. Our contractor’s estimator and the insurance companies estimator each prepared xactimate estimates, then my contractor walked off the job. I told the insurance company I would be happy to use their xactimate estimate, but I want to know that I am getting credit for the replacement cost of the historic details in my home. I see that the estimate includes a skim coat of plaster to approximate plaster walls, but I don’t think the database used includes, e.g. 7″ solid wood moldings around doors, or 10″ solid wood baseboard moldings. Also, the floor is heart pine, and I don’t think the estimate includes replacement with comparable flooring (only about 20% of the floor needed to be replaced). I assume that the replacement cost of items like the wood trim I mentioned would exceed whatever is in the xactimate database. Shouldn’t the insurance company pay for, e.g., custom wood moldings, even if I actually just use standard MDF moldings for the restoration? Do any of your ebooks cover claims for historic buildings? Where can I get the help I need? Thanks!

  1634. September 30th, 2013 at 9:54 am #Jason

    Pyar,

    The policy provides that you are paid an allowance for what has been damaged in order to replace the damaged items. If you have a standard HO-03 policy, which I suspect you don’t because of the age of the home, it will contain the following language:

    (1) the amount actually and necessarily spent to repair or replace the damaged building; or
    (2) the cost to repair or replace the damage:
    (a) using materials of like kind and quality; and
    (b) for like use.

    Going a little further, I’ve been able to find baseboard trim up to 10″ in xactimate and is listed below:
    “Baseboard – 10″ hardwood – 2 piece”

    If you have concern about your door trim, xactimate contains the category for oversized trim up to 12″ with this type of line:
    “Trim board – 1″ x 12″ – installed (hardwood – oak or =)”

    Eactimate has some limitations but trim, casing, and baseboard is not one of them. Get a trusted contractor for the repairs needed to your home. Your contractor should be capable of repairing your home using commonly available materials.

    You ask where can you get the help you need – Well, the most important thing is getting a trusted contractor that can repair the damage. I don’t know of any other help you might be looking for.

    Also, based on the age of your home, you may not have a replacement policy. It may be an actual cash value policy. I don’t know this for sure but would expect it to be ACV only.

  1635. October 3rd, 2013 at 1:47 pm #Dawn

    Long story short. I had a storm chaser come to my home & offer to access my house for hail damage. I in fact did have hail damage on my siding. I called my insurance & they sent someone out. Next thing I know I got a check in the mail. When I asked the contractor what was all covered,he was acting really fishy,so I called my insurance company. They informed me that I do not have to go with that company. I am a little confused.
    Replacement cost value $28,000
    Less Deprecation $9,000
    Actual cash value of $18,000
    minus deductible $1,000 net claim $17,000
    Net claim If depreciation is recovered $27,000
    can you tell me if I got a bid for $17,000 do I got the remaining money after the siding is back on? My check was for $17,000

  1636. October 3rd, 2013 at 2:05 pm #Jason

    Dawn,
    The expected total amount of your storm damage is $28,000. It likely includes your roof and your siding. If you can repair all the damage for $17,000, then you will not receive any additional funds.

    However, if it costs $25,000 to fix the storm damage, you can make a claim for $7000 of the total amount of $9000 in reserve that is called recoverable depreciation. Your policy limits the time you can make an additional claim for any amount above what you initially receive. That time limitation is outlined in your policy and can be 6-12 months. Check your policy to determine the exact time you have.

    If the actual cost to repair your storm damage is $30,000, the most you can collect is $9000 (unless you have the estimate adjusted to account for the added cost of $2000.

    Always use local and trusted contractors to do any work on your home.

  1637. October 3rd, 2013 at 3:17 pm #Dawn

    No the insurance agent said just siding,my roof is fine. When I told him that I didn’t want to go with the original contractor he said that was fine,but in order to go with someone else(my brothers) they had to under bid him. So where does the RCV come in? This is what the agent said to me. But I KNOW HE IS NOT MY FRIEND LOL
    This is what we call and ACV value. WHen the work is done, we pay out the rest.
    We think the total to replace is somewhere around $28,000.
    Hope that helps.
    Call with questions
    Brian

  1638. October 3rd, 2013 at 3:34 pm #Jason

    Dawn,
    In which state is your home located? It is very, very likely that if hail of the size and density that caused damage to your siding, that your roof is also damaged.

    If you want your brothers to do the repair, they can do so and match the estimate your claim is based upon. They do not have to under-bid it – matching the $28,000 estimate is acceptable.

    If you want, you can respond directly to my e-mail (in orange lettering) at the top of this page.

  1639. October 3rd, 2013 at 4:48 pm #Dawn

    I sent you a message.

  1640. October 3rd, 2013 at 9:28 pm #Christy

    Admin,
    I am first time home owner (for a mere 7 months now) and I am not sure how exactly this homeowners insurance stuff works. We live in Texas and have Foremost Lloyds Of Texas insurance. It appears that I have a busted water pipe in the side yard near the drive way. Also in this side yard very close to the busted water pipe is an electrical pole, and the water main cut off. The wet spot in the yard is right at the edge of my driveway. Is this something homeowners insurance covers? I have read through policy several times, but I am so confused.

  1641. October 16th, 2013 at 10:36 am #Dawn N

    About a month ago, I noticed leaking coming from the walls in my basement.
    I do not know how long this was leaking for because I had my sister living in a room down there and all the boxes from that room were all over the basement. There was literally paths to get to anything. Now that she moved out and we started to put things back is when we seen the leaks.
    I called my insurance agent the very next day. I was told to get the quotes from a plumber, then call the claims department with the quote. I even asked the agent for a referral. They gave me a restorations information. I called them and they came out 2 days later.
    The restoration company told me that it looked like it was leaking for a while and that I needed to get a plumber out.
    I called a plumber and he came out about a week later. Showed me in 2 seconds where the leak was coming from. He gave me a quote.
    I then called the claims department (Allstate). I was told that since I didn’t make the claim right when I seen the leak that it may not be covered. She said but since I did call my agent, she would have to look into it. For 4 days for little calls from the claims department, I was asked small questions about the leak, such as how long the leak was for and is there any kind of mold. Yes, there is mold.
    After the 4th day, I was told that they could not do anything for us because by the look of the pictures it looked like it has been leaking for a long time.

    My question is, can I get denied because of a long term leak and that I did not even know about??

    Thank you,
    Dawn N.

  1642. October 16th, 2013 at 4:52 pm #Jason

    Dawn,
    You say your walls are leaking. You had a plumber come out and he told you immediately where it was leaking from.

    After reading your post twice, I have no idea what the source of the water is. That’s kind of important. Did the water cause any damage or is it just that the walls are leaking?

    Whatever the plumber found, does it have to be fixed regardless of whether its covered by insurance or not?

    I am unable to answer your question about long term leaks in walls because I have no idea where the water is coming from.

    Since we are talking about insurance, you may want to do a little research on your current insurance company right away and make an informed switch to another company. Claim satisfaction from Allstate claim customers are consistently rated very low.

  1643. October 16th, 2013 at 4:59 pm #Dawn N

    Water is coming through the bottom the drywall. The plumber said it is the pipe under the floor. Drain release pipee.?? The basement floor has to be torn out to get to it. Yes it has to be replaced because there is mold starting on the drywall.

  1644. October 16th, 2013 at 5:26 pm #Jason

    Dawn,
    Since I still don’t know the source of the water, I’ve copied a section of a typical home owner policy for you to review. Since I don’t know the details of your situation, perhaps you might be able to see how this applies to your water issue.

    ********
    6) Water, Humidity, Moisture, Or Vapor — “We” do not pay for loss caused by:
    a) continuous or repeated discharge, seepage, or leakage of water; or
    b) the presence or condensation of humidity, moisture, or vapor;

    over a period of weeks, months, or years, unless no “insured” knew of or could reasonably be expected to suspect such discharge, seepage, or leakage of water or the presence or condensation of humidity, moisture, or vapor.

    ************

    The language won’t be exactly like this in your policy but it will probably be very close.

  1645. October 24th, 2013 at 11:45 am #Stephanie

    I am needing some help with homeowners insurance in the state of Colorado. We had a claim filed 11/12 for $60k for water loss. We were covered with Progressive underwritten by ASI and our claim is still open. ASI dropped our coverage effective 10/1/13 due to our home having a metal roof, and said they never should have covered us. I know they dropped us because of the claim. Now the problem is we cannot get coverage anywhere because our claim is still open and won’t be closed until at least next summer due to the repairs. Wells Fargo is our mortgage lender and are requiring homeowners insurance, obviously. Any help or advice on how we can get coverage until our claim is processed?
    Thank you.

  1646. October 24th, 2013 at 1:56 pm #Jason

    Stephanie,
    Talk to your agent and have him find you another insurance company. An open or closed claim should not affect your ability to be insured by a different company. If you are not getting any options with your current insurance agent, find another agent to find you coverage.

    The insurance the bank gets is paid entirely by you, the homeowner, and their insurance protects only the bank, not you. Don’t let it get to the point where your mortgage holder places your home under their insurance program.

  1647. October 26th, 2013 at 11:49 pm #JB

    Jason,
    I live in Southern California and need some advice. My washer malfunctioned and flooded the wood floors in my home. AAA sent a contractor out to dry areas and wrote a bid for the claim to replace the floors. Many things were left off the claim. One huge thing was content manipulation, as all the floors in the downstairs will need to be demoed the whole down stairs will not be used for the entire time the floors will need to be worked on. So no housing for my family, no content manipulation. Do not want to use this contractor so AAA sent me a check for $15000 what the contractor said it would be to fix floors. What should I do. I want to do the work myself. My mortgage company is Bank of America. Will they require me to hire a contractor? I I do the work and there is money left over am I entitled to it? The claims adjuster never came out to the house to see the scope of work. Should I demand he come out? He just went by the contractors estimate. Should I have contractors out to give me bids on repairs. what if they wont? HELP PLEASE?!?!?!

  1648. October 27th, 2013 at 9:22 am #Jason

    JB,
    ABout the contents manipulation, talk to the AAA adjuster and request that an allowance be made for that. If it’s likely the house won’t be habitable during the time of repair, make a reasonable estimate of that duration and present that to your AAA adjuster. You will have to justify this part of your claim because repairs can generally be done to acommodate continued living even if part of the downstairs have to be blocked off. That would be a claim from your policy under the provision of LOSS OF USE.

    You should only use contractors that you are comfortable with and trust. If you don’t want the current contractor involved anymore, excuse the contractor, and if you have to tell him he’s fired, do that.

    We don’t know what mortgage holders require of their customers. Call them and find out. They may hold onto the insurance funds until the work is completed.

    The only reason to have the AAA adjuster out to your home is if you believe a personal inspection would be beneficial to you and if the estimate should be higher. If the estimate is adequate for the contractor, it probably is adequate for the needed repairs.

    Yes, if you need more info, get other contractors out to provide you with their estimates. I can’t imagine a contractor refusing to give you a bid because that is how contractors get their jobs – by giving estimates.

    Finally, the part about if you can do the work yourself. It’s your home and you can do anything you want to your property. With that said, CA is a highly regulated state and there may be laws or ordinances in your area that dictate whether you can do the work or if contractors are required. You would have to check on that.

  1649. October 29th, 2013 at 7:14 am #Deb Buzza

    The dividing wall was blown down due to storm and it smashed the neighbours window. It is my wall so put in a claim and was told that we were not covered by our insurance as we had a fence attached to it. Our insurance states we are covered for storm damage. The neighbour was told to go through her insurance to put a claim against my insurance. Will the neighbour have to pay their excess

  1650. October 29th, 2013 at 7:26 am #Jason

    Deb,
    You did not cause the wind to damage your neighbor’s window. You have no obligation to your neighbor for any damage caused by wind.

    If you have a standard HO-3 homeowner policy, it covers wind damage to walls and fences. It doesn’t matter if a fence is attached to something or not. It should all be covered. Did they give you the “not covered” notice during your call to make a claim? If so, they are assuming there is no coverage. Have them send someone out to investigate the damage.

    Since you are not responsible to your neighbor for damage caused by wind, it doesn’t matter if your neighbor has to pay excess, their deductible, or anything else -that’s what their insurance is for.

  1651. October 29th, 2013 at 7:31 am #Deb Buzza

    They sent out an engineer and he said that because we had a fence attached to it we wouldn’t be covered. We have standard cover for building and it states storm damage covered

  1652. October 29th, 2013 at 7:45 am #Jason

    Deb,
    What policy do you have? The policy information can be found on any page of your policy and is either at the lower part, or upper part, of each policy page. Also, which insurance company?

  1653. October 29th, 2013 at 8:16 am #Deb Buzza

    Found out that the engineer who put in a report about the damage has said that, it fell down due to wear and tear and the storm just added to it. He never mentioned anything about it having a fence attached to it which is what he told me is why it fell down it acted as a sail. I have Contents & Building. Standard building cover which clearly states damage caused by storm etc. The policy also states that it is a 1920 brick built but the engineer has said that as it is around 90 years old, the wall is coming to the end of it’s life.

  1654. October 30th, 2013 at 2:09 pm #Jason

    Stacy,
    See solution under “denied insurance claims”.

  1655. November 2nd, 2013 at 5:47 am #Jose

    Hi

    Great website and I would like to thank you in advance in providing this type of information. It’s sad with current insurance company practices that they will always find a way to NOT pay you.

    Ok , here is my story and questions. I own a property in South Florida that I bought in 2009 and lived until mid-July 2013. I left South Florida and moved to Alabama for a new job. I used a reality company to rent the home out and the renters moved in August 2013. Everything was ok. Until mid October 2013, my neighbors from south florida called and told me the police raided the house. The tenants were using the home as a grow house for marijuana. The first thing I did was contact a childhood friend of mine and who is a lawyer for 2-3 yrs now. He went to the house and saw the condition and ever since then he is actively doing everything for me in my absence, until I will come down next week. I have citizen home insurance. The adjuster has already come out and did what he needed to do. My friend and I are just not knowledgeable on how to deal with this and get what is due to me.

    We are doing our research and what we understand this will all be covered under vandalism. But what we don’t understand is with the tenants at the home will there be a exclusion to my claim? What is the differences between a regular home owner policy and a landlord rental policy? Does one policy type cover vandalism caused by tenants and the other doesn’t? I have I think all the proper or typical insurance coverage as my home still has a mortgage. I called one company also who does mold inspections and then learned they also do everything else from dwelling repairs, constructions, electrical , plumbing and all architect plans if needed. They are licensed for everything and it seems like a one stop shop. They also know how to deal with grow houses and the company referred me to certain public adjuster to help with the claim. Its kinda nice because with them I won’t have to do anything, they will do everything from beginning to end. But I would like my friend to use my situation as a learning lesson as long as he figures it out and gets the job done. ( unless all fails, I will ask for their help) In my ordeal we will need permits for structural plans, electrical and plumbing and bring the home to proper living conditions. All the requirements are from the building-code inspectors assessment that happened a week before.

    So I want to get your feedback and also which book do I buy from your uclaim website? My friend is doing his research and he also has some friends who are public adjusters. My friend is in the process of consulting with his friends and getting the right info to arm him against the insurance adjusters. But I want to make use of your guys help also and the ebooks from uclaim website, if it will arm us against the insurance adjuster on a higher level. Right now we both are just in the beginning stages of everything. So what do you guys think and what should we know before all the games may begin with the insurance company?

  1656. November 2nd, 2013 at 7:28 am #Jason

    Jose,
    No, this won’t be covered under the premise of vandalism. Vandalism is defined as an action involving deliberate destruction of, or damage to, public or private property. There was a purpose to what the tenants did to change the constructs of the home to a grow house. Nothing they did was vandalism. You contractually had an agreement with the tenants to live in your house for a rental payment. The lease contract probably even had conditions that they could not do illegal things while living there. They did – that would be their breech of contract with you and the action would be to withhold returning their deposit.

    Their “living” in the home was by contract and their “living” there cannot legally translate to vandalism. Some tenants live in a home without much wear and tear; some tentants cause very severe wear and tear to a home. I see no other outcome except that your insurance company will deny this claim.

  1657. November 2nd, 2013 at 7:37 am #Jose

    Thanks for the prompted reply Jason. How come I have found 2 public adjusters , one which was online and the other was the company I called .. say it will be covered under vandalism? I guess worst case scenario I just eat the cost! I guess lets see.

  1658. November 2nd, 2013 at 9:08 pm #PJ

    My father’s home sustained damage from a tornado. My father filed a claim with his HO insurance however he died before the claim was settled or the damage repaired. It is my belief the scope of damage is more than what the original estimate shows. Do I have an insurable interest where this damage and claim are concerned since I now own the home with my brother due to our father’s death?

  1659. November 2nd, 2013 at 9:42 pm #Jason

    PJ,
    In a sense you will be able to act as an insured in the absence of your father, and then of his estate if you are the beneficiaries of the property AND the insurance coverage. Make your supplement claim and make it understood so the insurance company knows that their original assessment of the damage was not complete. You literally and figuratively take the place of your father as it concerns the tornado damage.

  1660. November 2nd, 2013 at 10:06 pm #PJ

    Thank you Jason for your quick reply. I did contact the insurance company and make them aware of my position. The 1st adjuster discussed the situation with me and told me to send in estimates and that he would discuss the matter with his manager. I have emails to show this as fact. When I attempted to send in the estimates (less than a month elapsed) the adjuster no longer worked at the company. I then contacted the manager and explained what I had done at the instruction of the adjuster. During that conversation the manager said he could only talk to me with the permission of the Executor. It was my thought that as half owner of the property I should be able to make a supplemental claim however the manager insisted although he wanted to help me he couldn’t without permission from the Executor. Does that sound right to you? The state of the policy is MA. Thanks again.

  1661. November 2nd, 2013 at 10:59 pm #Jason

    PJ,
    The only one that is autorized to deal with the claim is the executor of the estate. if you meet that definition, then you should be able to resolve everything. Half owner or 100% owner means nothing at this point. The property has to be transfered to the next owners through the executor. I don’t know who the executor or the new owners are so that is up to the court.

  1662. November 3rd, 2013 at 6:33 am #PJ

    Thanks again. The Executor is an attorney that was appointed by the Probate Court where my father resided. Now for the twist, when it came time for the Executor to file a complaint against the insurance company because enough time had ticked away to the point that the 2 yr statute of limitations was going to expire – the Executor came back stating in his opinion based on MUPC (MA Uniform Probate Code) 3-101 he had no standing to file a Complaint as based on the MUPC title to the real estate transferred to my brother and I and that we are now the owners not the Executor and that I or my brother would have to be the Plaintiff in a lawsuit. He states this opinion in 3 separate letters and I have a voice mail recording from him stating the same. I realize I have now bridged into the legal realm however from my perspective I am someone the insurer should have been talking to all along if I in fact the Executor is correct and I need to spend my own funds to file a Complaint. If the Executor who is an attorney is stating he has no standing should the insurer have been working with me to resolve this claim all along? Lastly, do you know of any resources I can contact to better understand this situation specific to MA HO claims involving death of the original claimant? Clearly with this code being cited MA has a unique non-standard twist or else the Executor is wrong and the policy overrides any state code. Do you know which would take precedent the MUPC or the insurers position as they are in opposition to one another as to who is the responsible party? Thank you once again!

  1663. November 3rd, 2013 at 9:54 am #Jason

    PJ,
    This is more complex than you think. The Executor distributes the estate based on a court ruling. Technically it is correct the Exector doesn’t have standing. In fact, until the property is transferred by a court ruling, nobody has standing. Not even you.

    No, the insurance company should not have been working with you to resolve this. From death until the time the court rules about the property, the state controls the property but only to the extent that it decides the next lawful owner. By court order, the Executor could have assigned someone to deal with the insurance issue, but that didn’t happen.

    There should be no conflicting issues between the policy and state law. The pecking order is that the policy trumps what happens if the policy is not in conflict with state law. If there is something that conflicts, state law prevails but only to the part that conflicts.

    I don’t know all the details of your situation but from the information I do know, I’m going to suggest you move forward without trying to change the situation. If the 2 year deadline has elapsed, that is a near impossible hurdle to fight and win. There is nothing that stops the tolling of days when it comes to a deadline that has come and gone.

  1664. November 3rd, 2013 at 1:04 pm #PJ

    Thanks Jason, this is even more complex than you know. I did file a Complaint against the insurer before the statute expired as that is what the Executor said needed to be done. I am paying the attorney fees for the complaint myself not the estate. Based on your answer it appears you are saying I didn’t have any standing to do so even though that is what I was advised on more than one occasion by the Executor.

    You mention that the property has to be transferred by court ruling however this is where everything become cloudy as the Executor cites MUPC chapters & sections stating that title to the real estate transfers to the devisees upon death. If he is correct that is a MA code that says my brother and I owned the property by title as soon as our father died. Does that change anything here as the Executor states we held title to the property as soon as my father passed away?

  1665. November 10th, 2013 at 11:05 am #new haven

    Hello

    Insurance co. paid me board for their client to stay in my home after a

    house fire. Will I have to pay taxes on that money?

    Thank you

  1666. November 10th, 2013 at 3:11 pm #Jason

    new haven,
    Your question is a tax question, not an insurance question. You should ask a tax accountant that question.

  1667. November 12th, 2013 at 11:17 pm #Bob Dinnerman

    My wife had a custom made diamond pendant her grandmother gave her on a stand alone policy with Farmers appraised at $14,500. There is one main 1.70 ct diamond worth about $12k and the second diamond is worth about 1 ct $2k; the other smaller diamonds are worth about $500.

    The pendant was stolen and filed a claim. I can’t find the actual policy in my file cabinet. Just got an email from the Claims office saying “they have authorized (I will not mention the jewelry store’s name but they work with Farmers) to move forward with the replacement of your wife’s pendant.”

    I don’t understand what this means? Are they going to try and re-create the pendant? Give us two similar diamonds? Give us a check for what they feel the pendant what they feel they could purchase the exact same pendant for now?

  1668. November 13th, 2013 at 12:53 am #Bob Dinnerman

    I’m sorry it was officially declared a “mysterious disappearance” since there was no sign of a break-in or vandalism in her aunt’s condo and nothing else was missing.

  1669. November 13th, 2013 at 6:30 am #Jason

    Bob,
    The jeweler has been given the o.k. to recreate the ring to your wife’s complete satisfaction. There are several companies that replace jewelry for people that are insured. One of the companies that does this is Gemcor. These companies will create a ring and send it to the insured for personal inspection and even to take it to a local jeweler to get it appraised and confirmed that the replacement item is legit.

  1670. November 18th, 2013 at 12:31 pm #Pat Roberts

    I had some damage to my roof and siding in a tornado that touched down in my neighborhood a few months ago. I contacted Progressive and they sent an adjuster out quickly and cut me a check. I am in the process of getting quotes for a new roof but some of the contractors want my insurance paperwork and want to “negotiate” with the insurance company directly before looking at my roof. I didn’t feel comfortable disclosing that information as I was instructed to get quotes from the necessary repairs. Should I be disclosing this information to these contractors so I can get the “best” repair possible? Thanks, this is a great site.

  1671. November 18th, 2013 at 12:55 pm #Jason

    Pat,
    Your insurance policy is a contract between your insurance company and you – and nobody else. Contractors have no business in your contract with your insurance company. The check and the estimate written by your insurance company should be sufficient to repair the damage to your home. If you find that it isn’t enough to make the required repairs, then you (not the contractor) should inform your insurance company of any shortage in funds.

    The only parties involved in a contract to repair the damage to your home include only your chosen contractor and you. Please notice that it doesn’t involved your insurance company.

    Find a contractor who you trust and who can do the repairs based on the information you want to share with them. There are many contractors out there that will do what you request instead of trying to fleece the insurance companies or you for as much money as they can possibly get. Stay away from contractors that insist on obtaining information they aren’t entitled to know.

  1672. November 21st, 2013 at 7:51 pm #Marie

    My daughter has taken over her dads house and vehicles, and raising her 11 yr old step brother after he died 8/23/2012. After burying him she split all the money he had available into 3 and dispensed it between three of them. The roof was damaged and Insurance Co has sent a check for the roof repairs. A lawyer she is trying to work with to get house into her name and truck is telling her she has to split the insurance check and give her half sister a third of the claim….is this legal , isn’t this insurance fraud? The insurance co pays out for repairs not personal use. The state is Topeka, Kansas, the lawyer is legal aid…are we wrong?

  1673. November 22nd, 2013 at 7:57 am #Jason

    Marie,
    The insurance payment is ear-marked specifically for the home’s repairs due to covered damage. Although the insurance funds can be used by the insured for anything the insured wants to use it for, that is impossible because he is dead. If the attorney is for the purpose of changing the title information to your daughter’s name, he should focus on that instead of an the insurance matter. I don’t know if the attorney’s role is limited to the name change or if he is involved in more.

    It’s not insurance fraud, but if an idiot attorney can convince others that some insurance money should be voluntarily paid to someone else, then the attorney is really influential or the people he is influencing are not that bright.

    The bottom line is that I don’t know the intestate orders or Will terms to provide any feedback.

  1674. November 27th, 2013 at 11:36 am #Jason Chambers

    I need to know if your in a open court case with a contractor and 180 days expires on the time frame to recover depreciation funds. Can you still recover depreciation funds on an home insurance claim?

  1675. November 27th, 2013 at 12:13 pm #Jason

    Jason,
    Nothing you do can prevent the tolling of 180 days outlined in the policy. The part of your policy that you are questioning is capied below:

    f) At “your” option, “you” may make a claim under the Actual Cash Value Terms instead of these Replacement Cost Terms. “You” may later make a claim for any additional amount payable under these Replacement Cost Terms, but only if “you” have informed “us”, within 180 days after the date of loss, that “you” plan to do so.

    The 180 days actually refers to your notice to the insurance company of your “planned” claim for recoverable depreciation. The company practice and policy of one insurance company I was affiliated with waived that condition of “notice” and allowed a claim for recoverable depreciation within 1 year. Although this applied to that specific insurance company, I don’t know the practice or policy of other insurance companies.

    The policy language I referenced above is actually silent about the time limitation to collect recoverable deprecation when proper notice is given before 180 days expires. Although most homeowner policies are very similar, your actual home owner policy may contain different language than the sample policy I use as a reference.

  1676. December 3rd, 2013 at 7:59 pm #Sally

    Hi,

    We came home to find water pouring into our downstair room from the master bathroom. The adjuster was out and gave the impression he was looking out for State Farm and not for us which holds true to what you said about their ultimate goal/job. They are now asking if we repaired/replaced the toilet pump at any time or if a plumber did. Will out answer impact our coverage? We answered truthfully but have not heard what will happen at this point. Any thoughts?

  1677. December 3rd, 2013 at 8:27 pm #Jason

    Sally,
    If the cause of the water damge is a contractor or plumber, the insurance can seek reimbursement from that party if their work was negligent. If you did any work, the insurance company runs into a dead-end because you cannot be liable to yourself, and the insurance company won’t be able to recover what they pay for your claim.

    You are obligated to answer their questions truthfully because truth and honesty is required of both parties to the insurance contract.

    Regardless of who did any work, if anybody, to your toilet pump, that alone cannot affect your coverage.

  1678. December 18th, 2013 at 7:50 pm #cindy

    hello, we owned a home that was underwater. we decided to try to shortsale the property. in the meantime, Sandy hit and there was wind damage to the roof. we contacted our insurance co and filed a claim. we hired a claim’s adjustor. in between the time of the finalizing of the claim we sold the property as a short sale in “as is” condition and are responsible for paying taxes on the difference between what the house sold for and what we owed. After that, we received a check from our insurance company made payable to us, the adjustor and the mortgage company. the adjustor says they are going to sue us for their commission. we signed the check and sent it to the adjustor. they then sent it to the mortgage holder who said they won’t sign it cause they no longer have any interest in the property. now the adjustor wants his commission from the check but we never received any money. are we entitled to the money from the claim?

  1679. December 18th, 2013 at 8:39 pm #Jason

    cindy,
    You hired a public adjuster, not a claim’s adjuster. There is a difference. Also, when you indicate your home is “underwater”, that means you owe more on your home loan than the property is worth – it has nothing to do with flooding or water engulfing your home.

    Regarding the tax on the difference – don’t pay taxes on that difference until the bank sends you a 1099-C form. Until the mortgage holder writes off the loss they absorbed on your property, the difference doesn’t become taxable to you. Believe it or not, some banks don’t write all their losses off and don’t send the required 1099-C form. (Until the bank writes it off, it doesn’t become their loss and your gain.) Please do not construe this as tax advise because it is not.

    You owe the public adjuster money for his assistance with your claim. You have a three-party check that the prior mortgage holder will not endorse. The mortgage company indicates it won’t endorse the check since it no longer has an interest in the property as the mortgage holder. No longer having an interest in the property is probably the strongest reason they should endorse the check. It seems your prior mortgage holder lacks common sense and logic skills.

    Contact your insurance company and ask what kind of documentation they require so they can cancel the current check and issue another check with only your public adjuster and you on the check. That should resolve your concerns.

  1680. January 10th, 2014 at 6:13 pm #Andrew Hale

    Hello there,

    Our home was declared a total loss by our insurance company after a house fire on September 1st.

    We have decided to move to another state and either buy an existing home, or build a new one.

    We had full replacement cost coverage and have been offered 317,000 – 202,000 of which is ACV.

    Can the insurance company dictate what type of home we build, what features and what styles it may have?

    For example, can we buy an existing home for 250,000 and make 67,000 of upgrades to it (such as adding wood flooring, new mechanicals, going from a 1-car garage to a 2-car garage, etc) without the insurance company’s interference?

    We live in Illinois and are considering moving to either Arkansas or Utah.

    Thanks in advance!

  1681. January 10th, 2014 at 7:14 pm #Jason

    Andrew,
    These questions should be asked of your adjuster. All the parameters of what you can and can’t do are outlined in your policy. I don’t know the exact language in your policy but generally, you should be paid $202,000 which is the ACV amount. You can build a home and then claim an amount up to $317,000 when the costs exceed the $202,000 amount. You have a time restriction of when you can claim the additional funds so be aware of that.

    I don’t know what conditions you have in your policy if you can build or buy at a different location. For the most part, the home does not have to be identical to the damaged home. The most important is following what your policy allows and what it restricts. Also find out about the debris removal allowances for your damaged home so you know what to expect and what’s available to you.

    You should ask your claim adjuster all the questions you have and you should request and receive it in writing so everybody knows what to expect. Also, find out what time limitations you have for the different parts of your claim. If you have a mortgage holder on the check, you can expect the mortgage holder to appear on the checks you receive.

    After you discuss this with your adjuster, just post again if you have other questions.

  1682. January 15th, 2014 at 6:36 pm #Scott

    Never had a home claim before so I have a question about recoverable depreciation.

    Hail storm damaged our roof and various other things on a home we used to live in but now rent out. Insurance said total was $14856.62, minus $500 deductible and $2957.56 in recoverable depreciation. Sow we are getting a check for $11,389.06. They said if we submit receipts showing the repair was done we would receive the recoverable depreciation.

    My question is, “if I have the work done, do I get the recoverable depreciation regardless of if it costs me that much to have the work done?” I have several friends (very reputable) in the roofing business who have offered to do the work for much less than it would typically cost. So if I am able to get the work done for, say, $10K, would I still get the recoverable depreciation, even though I was able to get the work done for less than the cash value? Or do I only get the recoverable depreciation if the cost of repair is actually over the cash value?

    Thanks!

  1683. January 15th, 2014 at 6:55 pm #Jason

    Scott,
    If you can get the damage repaired for $10,000, then the claim should be based on $10,000, less your $500 deductible. If you pay those people who are very qualified to do the work a total of $10,000, then there would be no need for the insurance to pay anymore and you are entitled to keep the excess because you were resourceful with the needed repairs.

    However, if the repair costs a total of $14,856.62, then the most the insurance will pay is $14,356.62. If you want to try to work the system, then that is the risk you take. This site is not designed to put cash in your pocket when insurance is specifically designed to allow for your direct costs due to covered damage, less your deductible.

    Futher, if your people do the work for $10,000 and provide you an invoice total of $14,856.62, then that crosses into the area of insurance fraud. I specifically discourage that type of conduct and will never condone that. I don’t care how much it costs to repair the covered storm damage but when people try to circumvent the system, you, as well as I, know that is not right.

  1684. January 16th, 2014 at 4:56 am #Scott

    Jason,

    Thanks for the info. Please understand, I am not trying to scam the system at all. I genuinely want to do the right thing. And I would never allow an invoice for more than what was actually paid to be submitted. I do know that this would be fraud which would be a felony (not to mention simply morally wrong!)

    Very sorry if I gave the impression of trying to “put cash in my pocket”. Not my intent at all. Simply trying to figure this whole thing out. My sincere apologies.

  1685. January 16th, 2014 at 7:51 am #Jason

    Scott,
    Another way to approach this is to get the repairs done whether you do them yourself, with others help, or both. Then make a claim for recoverable depreciation. This work needs to be completed before a certain time frame, such as 6 months, so make sure this policy time requirement is met.

    The logic behind this is that the insurance company concludes the total cost will be $14,356.62. When all the repairs are done, the total cost should be this exact same amount.

    Rather than sending an inaccurate invoice, you can confirm an invoice doesn’t exist since you did the work with the help of others and that you want the insurance company to come out and physically verify that all the damage was repaired. (Sometimes an insurance company will accept photos to confirm repairs.) The insurance knows materials need to be purchased and labor needs to be paid so visual confirmation of the repairs should be enough to assure them their estimated total costs of $14,356.00 have taken place and now need to be paid.

    If you do the repairs with the help of others, including your labor and resourcefulness to get the job done, you deserve to be paid just like anybody else that would do the repairs. It’s not really “cash in your pocket” because it would be earned because of your labor, time, and management of your home’s repairs. Accept my apology for using that phrase. Also you are a first time home claim person with very good questions that I should take more time to explain instead of a quick response. Post again if you have other questions.

  1686. January 29th, 2014 at 9:21 pm #Brian

    Jason,

    We had a recent hail storm that required us to replace some siding. The adjustor gave us a value of $7k for replacement cost, $6k for ACV, and $1k in recoverable depreciation. I have a deductible of $2,500, so they sent me a check for $3,500. After getting the check I got a few additional quotes and was able to get the work done for $3,700.

    I sent in the final paid in full invoice confirming the work was completed assuming they would release the recoverable depreciation. They said that because my final bill was less than the quoted amount than I am not eligible for this money.

    I was wondering, am I entitled to any of the $1k recoverable depreciation?

    Thank you.

  1687. January 30th, 2014 at 7:13 am #Jason

    Brian,
    So you got the work done for $3700 and the insurance company sent you $3500 after applying your $2500 deductible. In a sense, you paid a $250 deductible for this damage which saved you $2300 by shopping around. In this case and how your presented your recoverable depreciation claim, you are not entitled to the recoverable depreciation.

    If you had done the work yourself, with the assistance of the contractors that you paid $3700 and you informed the insurance company the work was done, your claim may have ended differently. In this example, you would not have submitted any final invoices but invited your insurance company to inspect the completed repairs, then you would have a claim for recoverable depreciation that the insurance company would likely have honored.

  1688. January 31st, 2014 at 3:07 pm #stephanie

    Good evening,

    I live in south florida and has been in my home for over 5 years. for the past week it has been raining none stop and roof starts to leak. my husband went on top and notice a quarter size rope.. we call an adjuster and he state that southern fidelity insurance will not cover unless its hurricane related. Are you familiar with that company

  1689. February 1st, 2014 at 3:06 pm #Jason

    stephanie,
    I don’t know what you mean by a “quarter size rope” and I am not familiar with southern fidelity insurance. I’ve noticed florida and the lower, southern states are actively minimizing coverages relating to certain types of water damage.

  1690. February 3rd, 2014 at 10:15 am #Tracy

    Hi Jason, we have a Nationwide Ins. Replacement value policy. We had a house fire in August. The next morning, the Nationwide adjuster showed up along with a restoration company he had called to start removing contents. Day 5 the house was still full of debris. The adjuster was pushing them to get it out. Day 7 still full of debris. We had a lot of smoke and water damage. Most of the ceilings had fallen in so there was a foot and a half of debris in most rooms. We were told mold sets in after 3 days. It was over 100 degrees every day that week plus the humidity. We live in Missouri. Labor day weekend was coming up so the cleaning crew would not be back for 3 days. My husband, son and 4 of his friends went in with shovels, wheelbarrows and used a bobcat to get the debris to the dumpsters. Come Tuesday the clean up crew was back but the house was empty and the floors were drying…we submitted a bill to the restoration company. We felt the boys should be paid…it wasn’t their job to muck around in that mess. We have yet to see a dime. We built the house 17 years ago for 135,000.00…our coverage was for 217,000.00. At this time, we are at 220,000.00 and there are still things that need fixed and replaced. The insurance seems unwilling to do much more. Our agent told us we have a 25% clause in our policy so we should be fine. Our house is paid off. We built it ourselves. We know what we put into it. If my husband wasn’t watching everything they do, we would have a house worth half of what it was. Don’t we have a right to expect that we will be put back to where we were to the best of their ability? We just want a safe livable house! It seems they are trying to cut corners. It’s not right…we faithfully pay our premium on time every month, and have for years. And furthermore, beware people…when the restoration company told us they were sent by Nationwide to remove our contents and restore our house…we signed their contract. We didn’t know we had a choice. We had not slept all night…we were devastated and traumatized…no family was with us at the time…and we made a big mistake. It should be against the law what they have done. Do you have any insight into this Jason? Any input would be appreciated.

  1691. February 3rd, 2014 at 12:18 pm #Jason

    Tracy,
    Regarding the cleaning and disposal by your husband and his guys, you should send the bill to your insurance company and explain, in writing, why you are presenting that bill.

    Nothing you wrote would indicate the restoration hired your husband or his guys so they have no obligation to pay a bill for labor and disposal.

    You always have a choice to sign something or not. Just be wary of everybody you encounter and read (and understand) everything before you sign it.

  1692. February 7th, 2014 at 5:18 pm #Andrew Hale

    Our home burned down in Illinois, is a total loss, and we have a Guaranteed Replacement Cost policy with Erie Insurance Company. The policy is entitled “Ultracover HomeProtector Insurance Policy.”

    We would like to buy a new home in Arkansas. We would like to purchase the new home using the total ACV and depreciated amount from the insurance claim.

    Within the policy it states, “We will pay no more than the actual cash value of the damage until the actual repair or replacement is completed.”

    In this case, they have offered us $317k – $203k of which is ACV.

    At what point is the insurance company responsible/required to pay us the depreciated amount to cover the additional cost of the new home?

    I ask because we need the full amount at the time of closing. We don’t want to incur the expense of getting a very short-term loan/mortgage to cover the gap in between the time we close on the new home and the time the depreciation check comes from the insurance company.

    Any suggestions on how we can make this happen in our favor?

    Thanks in advance!

  1693. February 7th, 2014 at 5:48 pm #Jason

    Andrew,
    In all reality, there is no way for you to get additional funds before closing. The replacement provision of your policy states when repairs or replacement are completed, you may make a claim for recoverable deprecation. Notice that this is after replacement, not before or during.

    Talk to your adjuster, or his/her manager, to discuss your options and plans. Get everything in writing so there is no misunderstanding of what will happen or when funds will arrive. Since that is where the money is coming from, you will need to work with your insurance company.

    Perhaps you can arrange something with the seller. I don’t know. A short term loan may be your best option. Purchasing a home is not part of the insurance topics that are talked about on this forum.

  1694. February 18th, 2014 at 5:06 am #JoJo

    We recently had a pipe burst on the main level which ruined the dining room hardwood flooring as well as the basement ceiling. The insurance adjuster came out and said they will replace the basement ceiling.

    For the main level flooring, the hardwood continues into the hallway, foyer, and living room. The adjuster said that since the floor continues into those areas, they will replace the foyer and hallway as well so it’s all continuous. But they will not replace not the living room floor because there’s a small piece of wood across the doorway, giving it the appearance of separation.

    We cannot replace the flooring with the same material or color because not only is it 30+ years old, but it’s also discontinued. The new flooring, even what we can get close to the original, is still markedly different. The foyer and living room flow into one another – there is no door between them. The adjuster herself said that all the other flooring would need replacement because it won’t match and will affect resale value; wouldn’t that also apply to the living room?

  1695. February 18th, 2014 at 8:41 am #Jason

    JoJo,
    Your homeowner policy covers direct damage, and doesn’t cover indirect damage. Matching is indirect damage and matching is not a covered cause of loss in your policy.

    It makes sense that a continuous flooring area is removed and replaced because of a part the continuous area is damaged. Since there is a transition at your doorway into the living room, it makes no sense to remove undamaged LR flooring and replacing it with new flooring – even if the exact same flooring isn’t available.

    Court rulings on the matter have considered transitions such as inside corners, outside corners, ceiling/wall corners, elevation change, transition break, physical separation (upper vs. lower) island counter, etc. are appropriate areas that define a components “continuous” properties. Your adjuster is technically and legally correct wih his/her parameters.

    Insurance companies want their customers to be satisfied since dissatisfied customers complain to their claim adjuster, claim adjuster’s manager, agent, friends, family, insurance commissioners, etc. Paying more can sometimes alleviate dissatisfaction of their customers. On occasion insurance companies will make an exception if they want to stop you from complaining. The insurance company’s exception may depend upon the claim satisfaction rating/practices of your insurance company.

    Provide your insurance company with an estimate to replace all of the flooring (including LR) with a statement from your contractor that the contractor insists on the LR flooring replacement with reasons why the LR should be replaced with the rest of the flooring. Prepare your arguments and argue for the LR so the job looks complete rather than cobbled.

    My opinion is that the insurance adjuster is appropriately addressing what flooring area should be replaced due to the water damage.

  1696. February 18th, 2014 at 4:23 pm #PattyG

    I called my insurance agent (representing Hanover) this morning, as water was running down the walls inside my house. As we’ve had so much snow in NJ recently, I suspected this as the culprit, so I called my roofer also. He got up there and chiseled at the 8″ of ice he said he found in the gutter, clearing it all out. The roof is not flat, but has a slight pitch, rolled roofing with 50% overlap and ice shield over 100% of it.

    My agent recommended called ServPro, as they’ve dealt with them several times and trust their work. She was also faxing the claim to Hanover. ServPro wants Hanover’s opinion to see if they should wait a few days (expecting thawing temperatures) before coming to dry everything, if more water will come in during the thaw. Agent said I should hear from Hanover within 24 hours. I’m worried that the water is behind the sheetrock and through the fiberglass insulation.

    1) Will I get into trouble waiting a few more days? I’ve done all I can to prevent further damage…catching with bowls, towels, pulling up carpet & drying with fans.

    2) My mother-in-law asked: if changing the pitch of the roof (redesigning it) would alleviate future claims, wouldn’t the insurance company pay for the new roof? I didn’t think so, but it doesn’t hurt to ask!

    THANK YOU for this site…it’s the only one I’ve seen like it!

  1697. February 18th, 2014 at 4:44 pm #Jason

    Patty,
    Keep your home as dry as you can. Your first obligation is to protect your property – even though it’s insured. Minimizing damage is one of your policy requirements. Stopping the water from coming in is the best way to address your water damage situation.

    Although your roof is nearly flat with rolled roofing and ice/water, it is seeping in through the seams and/or at the perimeter (outer edges) of the roof section. You may need to have the snow removed from the roof to minimize the amount of water coming in. Do what you need to do to protect your property.

    I don’t agree with Servpro’s delay. Servpro could even remove the snow from this roof section for you. I think it would be wise to get someone out there asap.

    The insurance policy is a reactionary contract. It reacts to covered damage. It will not alter your home to prevent any possible future damage.

  1698. February 24th, 2014 at 4:17 am #Maxine

    There was an arson attack on my home 2013 I had received a criminal record after I took out the policy I informed the insurance company through there website via email page but they say I did not disclose this information. After they received my subject access request they still took two months payments from my bank.

  1699. February 24th, 2014 at 7:28 am #Jason

    Maxine,
    By reading between the lines of your vague and unclear post, I take it that you were convicted of arson for the 2013 fire to your residence. After the insurance canceled your policy, while giving you the required minimum 60 day notice, they took 2 additional payments to keep it in force until the policy was no longer in effect. Did you have a specific question you wanted to ask?

  1700. February 27th, 2014 at 3:46 am #Lauren

    My house burned down about 9 months ago. June2nd 2013. It’s been 9 months and still we are under investigation. We did a swore statement under oath 4 months ago and they want us
    To sign and return the meeting that has been typed upby a court reporter. Do I sign? They have put me through heck and back. They haven’t paid anything but a couple small changes advanment checks. I had to sell my vehicle to be able to offord extra living costs such as rent I wasn’t use to paying. Isn’t it the law that a claim
    Has to be settled within a year? I need to know if I need to retain a attorney or sign the sworn statements and return them like they asked me to. I just don’t believe anything my adjuster says because everything he has said has been a lie. Please help me.

  1701. February 27th, 2014 at 5:48 am #Jason

    Lauren,
    There is no law that dictates within what length of time a claim should be settled. There are reasons why your claim is receiving extra scrutiny and I don’t know why without more information.

    It sounds like you did an examination under oath and they are asking you to sign the transcribed portion of the EUO to confirm its contents. They are asking you to sign it to confirm that the output of the EUO, in written form, accurately reflects the oral part of the examination. If the contents of the transcribed document are incorrect or not accurate, you need to have it corrected before you sign.

    You should seriously consider retaining an attorney for your situation. A claim denial is a form of claim settlement and you may have to prepare for that outcome.

  1702. February 27th, 2014 at 5:57 pm #Bob

    A car ran into my yard destroying 3 large 14′ bushes and a section of fence. The adjuster said he would write it as needing all 32′ replaced. A letter of settlement from the insurance company states there were just 2 bushes and that they would pay only for repair of 8′ of panel and not the posts on either end or adjacent panel damage, much less the 32′ section .

    After speaking with the insurance company claims adjuster about the above, they stated that they would only pay for what was directly destroyed and that the fence not matching was of no concern. They also stated that they were being especially “kind” not to factor in depreciation of the fence and bushes.

    Am I entitled to a fence that matches-it shows from the front of the house? Will I be required to pay for the third bush and the damages to adjacent panels myself and request a supplemental payment as they suggested? How do I prove the other damages to their satisfaction?

    Thank you very much,

    Bob

  1703. February 27th, 2014 at 6:28 pm #Jason

    Bob,
    You have a couple of options. Probably the best is to submit this to your own insurance company and let them settle it with you. You will have to pay your deductible but your insurance company will collect that from the driver’s insurance company and return it to you. If the fence and bushes are covered at replacement cost, the net amount you should have out of pocket is $0.00 when it’s all said and done.

    The other option is to get a contractor in there to give you an estimate and work with the driver’s insurance company so the repairs to the fence and the replacement of the bushes can be completed in a reasonable fashion. You have to remember that the driver’s insurance company only owes the ACV value of the damage and not the full replacement cost of the bushes and fence.

    I recommend you submit this to your insurance company and not to settle this with the driver’s insurance company. If you’ve already received the check from the driver’s insurance company send it back and let them know you are submitting it to your insurance company.

  1704. March 3rd, 2014 at 12:03 pm #Ma

    I have a couple of questions. I had a broken pipe in the ceiling which damaged alot of my house. The insurance company accepted my claim but sent me a pittance along with a ridiculous Xactimate estimate. My questions: 1. Do I have to respond with a detailed line by line estimate that is comparable to Xactimate? My preferred contractor tells me that he and his subs (drywall, paint) only estimate by the whole job, bunching all the rooms together. 2. If the answer to #1 is yes, does your book tell how to do this? 3. Is there a time limit to respond? This happened 3 months ago and I dont even have an estimate from my contractor. 4. Am concerned about future mold in the walls that were not torn out. Do I have any right to expect the insurance company to pay for them to be torn out and redone? Thanks so very much. Am eagerly awaiting your reply. Ma

  1705. March 4th, 2014 at 8:48 am #Jason

    Ma,
    More detail in an estimate for damage is preferred by the insurance company so they can compare the estimates more accurately.

    If your contractor is telling you that he just does total estimates, he is lying to you. In order to determine the total of a repair job, they need to know the individual components of labor costs and materials, so in some fashion he is purposely omitting that information. If he is just giving a total, he is not being honest with you.

    If you don’t have an estimate from your contractor and 3 months have passed, you should not be referring to him as “your contractor”. Instead he should be referred to as the “the contractor I fired”.

    You should be concerned about mold. It’s your home and you need to hire a qualified, capable, honest, and trusted contractor to do the repairs. Your trusted contractor should be able to work with the insurance company and work out all details of the estimate and payments for the repairs. If the damage is related to your claim, it should be covered by insurance.

    First things first – GET A TRUSTED CONTRACTOR.

  1706. March 4th, 2014 at 10:25 am #John

    I live in California and have AAA insurance. I didn’t uste their contractor and the adjuster took almost 10% off the full claim amount because their contractor is their “preferred contractor” Am I entitled to the whole claim. If I am how can I get the discounted amount back. its about 4000$

  1707. March 5th, 2014 at 6:40 am #Tina

    Our Insurance Co is cancelling our HO policy unless we paint and re-roof our house within 3 weeks. It is sub zero weather here and contractors will not begin ANY of it until decent weather (We have signed contracts with the contractors to do the work, once we get above freezing weather). Isn’t there some clause somewhere in which the Ins Co has to allow us time for this?

  1708. March 5th, 2014 at 3:49 pm #Jason

    Tina,
    Ask for more time. Or, ask for a roof exclusion until your new roof is put on. Ask your agent to help you and ask for a reasonable amount of time to get the roof replaced. Give your agent the signed contracts or give the contracts to your underwriter so they know that you are going to have it done as soon as possible.

    They can do what they’re doing and there is no clause or any law that indicates that they can’t do what they are demanding. Just like you can stop being insured by them by canceling and using free choice, they can stop insuring you unless certain things meet their standards.

    Just buy yourself some time with the help of your agent.

  1709. March 5th, 2014 at 3:50 pm #Jason

    John,
    That is being any help that can be offered here. You are allowed to use any contractor you choose. You may have to talk to an attorney on this one.

  1710. March 5th, 2014 at 4:19 pm #John

    Jason it’s john from ca about AAA claim. I didn’t understand your response, you think I should consult an attorney about them holding the discount?

  1711. March 5th, 2014 at 7:27 pm #Jason

    John,
    Sorry, yeah that message makes no sense. Sorry. I don’t know what arrangement took place and why things happened the way they did. I am not familiar with any practice such as what you described. Perhaps your best move is to talk to an attorney.

    Maybe before talking to an attorney, have your insurance adjuster explain to you why they are withholding 10% from you. Have them explain it so you understand it. When you fully understand what they did, ask for clarification in writing, or what wording in your policy, that indicates they can do what they did.

  1712. March 6th, 2014 at 4:49 pm #John

    Will my insurance company pay for out of pocket meals if they put my family and I in a condo that has a working kitchen. Will they pay for extra miles to and from my house to feed and water the dogs that we had to travel each day? How would I bill them if they do? By the mile or show gas receipts?

  1713. March 6th, 2014 at 5:36 pm #Jason

    John,
    Additional living expenses in a homeowner policy is a fairly open-ended coverage that is not well defined. There are varying ways and considerations to reimburse costs under this coverage. Reimbursement depends on your claim adjuster. If you want to know if certain things will be reimbursed, simply ask your claim aduster for clarification.

    If you don’t have utensils, pots, pans, etc. with which to prepare meals and eat, it would seem eating out costs would be acceptable – regardless if you have a kitchen or not. Save all your receipts and submit them as your additional living costs claim. However, if you will be displaced for a long period of time, it may make sense to purchase cooking and eating supplies so you can eat at the condo and to submit those receipts for the cooking and eating supplies for reimbursement. There is no right or wrong way how things should be done. Every family situation is unique.

    Your policy should pay for travel back and forth to tend to your dogs. Just keep a record of the date and mileage back and forth each day and make a claim for mileage based on the federal allowance for mileage. I think that mileage rate is about .55 cents per mile.

    All-in-all, the policy should reimburse you for any additional expenses above what you normally incur because you are displaced from your home. A frugile family’s expenses will be mimimal, but a family that spends a lot because of displacement from their home will be much more. There is no set parameters to follow but common sense is part of it. For example, if your family dines on lobster and expensive meals daily because that is what you eat at home, and you can’t do that at your condo, then that should be a reimburseable expense. Tips are generally also a reimburseable expense.

    If you had cable or internet at your home but not at the condo, movie rentals or theatre tickets may be reasonable expenses. If your displacement is long-term, the hook up for cable/internet should be reimburseable as additional expenses – but then you wouldn’t have movie rentals or theatre ticket expenses.

  1714. March 13th, 2014 at 7:10 am #Chris

    Last night I arrived home to my hanging kitchen cabinets having collapsed as the wall and anchors. Sectiosn of the wood has cracked and split where the stove fan is located. Would this be covered by my Farmers Insurance policy and is it worth the claim? House and cabinets are 10 years old and finding exact match will be hard and have to replace all of the cabinets. Please advise. THX!!

  1715. March 13th, 2014 at 7:35 am #Jason

    Chris,
    Your policy has no provisions for matching. If you have to replace base cabinets, that would be at your expense.

    In fact, after a review of a typical homeowner policy, there doesn’t appear to be any coverage for the wall cabinets. The following is a coverage pertaining to Falling Objects, which the wall cabinets were:

    k. Falling Objects
    However, “we” do not pay for loss to:
    1) property inside a building, unless the falling object has first damaged an outside wall or the roof of the building by impact; or
    2) the object that falls.

    I reviewed the “Collapse” coverage and it brings me back to “Falling Objects” wording, and doesn’t appear to favor coverage.

    You won’t know the result of your claim until you make a claim. Regardless of what you do, find a better insurance company than the one you currently have. If you want to get an idea of the low claim satisfaction and high marks for being an unfair insurance company, research your current insurance company.

  1716. March 14th, 2014 at 7:24 am #Tulli

    Are appliances covered to be replaced if damaged by water damage?

  1717. March 14th, 2014 at 7:39 am #Jason

    Tulli,
    It depends. Not all sources of water are covered under a typical homeowner policy. I will give 2 examples. Water that seeps into the home, at or below ground level, and damages an appliance will not be covered. A pipe breaking and causing water damage to an appliance should be covered unless there are other limitations or exclusions that may apply.

    You also have another element of your question that should be explained. You asked if the appliance should be “replaced”. The policy provides the insurance company with the option of repair or replacement. For example, if it makes sense to replace the heating element and/or motor of a dryer damaged by a covered water loss, the insurance company can repair that appliance rather than replace it.

  1718. April 14th, 2014 at 6:58 pm #John

    I wonder if a patio and a front stoop can qualify as “other structures” and not part of the dwelling.

  1719. April 14th, 2014 at 7:29 pm #Jason

    John,
    I don’t know why you would wonder that. The dwelling has more causes of loss that apply to it, and also some additional coverages that don’t apply to other structures.

    When you say front stoop, I assume that to mean concrete steps leading into the entrance of the dwelling. If it’s function is critical to the use of the dwelling, it is considered part of the dwelling. (If the steps were not there, how would one enter and exit the dwelling?)

    When you mention patio, that is a kind of vague. If it’s a flat concrete pad connected to the dwelling, it would likely be covered as part of the dwelling.

  1720. April 14th, 2014 at 8:17 pm #John

    Jason – I ask because my dwelling limit has been reached (under insured, apparently) and I have damage on patio and front stoop. They both need to be replaced. My “other structures” coverage has not been tapped. I would like to use funds from it to make repairs to those items… My adjuster has been evasive on what can be considered an “other structure” – almost as if he wants to keep the cost of paying out the claim as low as possible.

  1721. April 14th, 2014 at 8:31 pm #Jason

    John,
    If your dwelling limit has been reached, I can assume your dwelling is a total loss. Do you live in the dwelling as a primary residence? In what state do you live? I ask because of valued policy laws recognized by many states. There are extra expenses for debris removal and costs associated with code upgrades. Each of these can add a good portion to the loss total. Some policies allow the “other structures” allowance to be added to the dwelling if there are no other structures. Insurance can be complicated and you need to know the ins and outs of it.

    I don’t know enough about your loss to provide anymore information. Ask again if you have more questions.

  1722. April 14th, 2014 at 8:53 pm #John

    Thank you for your help. Your assumptions are correct. We lived in the dwelling as a primary residence. Now only foundation remains and has been confirmed structurally sound to rebuild on. State of MO. Fire loss. Policy states that 5% over and above dwelling limit can be used for debris removal and (the way I read it) another 5% over and above for lawn, shrubs, plant damage. $500 max per covered tree, shrub, or plant (on exterior). But there is a LOT of dollars sitting in “Other Structures” coverage that is laying on the table. Adjuster says it is for things he knows I do not have – aka swimming pool. I see no provision in the policy which says we can access the “other structures” allowance since I have no swimming pool, shed, gazebo, etc. In fact the policy seems to go out of its way to NOT define “Other Structures”. It also doesn’t say that “Other Structures” even have to be buildings of any sort. If the definition of this is a swimming pool or a shed, then why doesn’t the policy say that? Seems fishy to me. Thank you.

  1723. April 14th, 2014 at 9:43 pm #Jason

    John,
    You do live in a valued policy state. If your dwelling you live in is totalled, the insurance should pay you the face value of your policy no matter what. The additions to that amount should include debris removal and code upgrades, as applicabled. The debris removal and code upgrades may have to be incurred to be reimubursed.

    Although the language in almost all policies is very similar, there are some slight differences. Regarding the plants, trees, lawn, I won’t assume to know the damage to those items – if any. Any and all damage to your property should be part of your claim.

    As for the language if the coverage B (other structures) can be used to increase the coverage A (dwelling) coverage, I would need to know what policy you have. Your policy number can be found on any page of your policy and it is in the form of HO 03 07 12, for example. There are only a few policies that allow coverage B that can be added to coverage A if there are no coverage B structures.

    Sturctures that fit under other structures include an in-ground or above-ground pool, swing set, playhouse, electrical poles, detached garage, storage shed, clothes line/poles, ground mounted satellite dish, detached sauna, fences, exterior wood stove, employee quarters, etc.

    If during rebuilding, the lawn is damaged, that would account for up to $500 for the lawn, plants, shrubs. It’s all about negotiating for your best outcome. If you have other structures, they are pretty much obvious like detached garage or storage shed.

  1724. April 15th, 2014 at 4:20 am #John

    Thank you Jason – it is a HO 3 01-07. When you say face value of the policy do you mean just dwelling or also are you also including the personal property coverage?

  1725. April 15th, 2014 at 5:37 am #John

    Jason, maybe I should consult an attorney… look at this:

    http://www.moga.mo.gov/statutes/C300-399/3790000140.HTM

    Here is some of the fine print: (1970) Valued policy laws are not limited to insurance against loss by fire of improvements on real property but apply as well to policies of fire insurance on personal property. Duckworth v. United States Fidelity & Guaranty Co., 452 S.W.2d 280 (Mo.App.).

  1726. April 20th, 2014 at 2:54 am #Rick

    We lost our home to a house fire, totally destroyed including our two vehicles. ALE was pd. for our past two rental homes , not what we were use to. We had a large home and our present ones are much smaller. We want to go and live at our cottage, which is very nice and looked at other resorts in the vicinity and have got quotes for rentals. I gave the insurance the price on what we would expect for our cottage and they do not like the price we quoted them, much more than previous rental. How do I attack this situation, are they expecting a discount because I own this or should they know I own this?

  1727. April 20th, 2014 at 8:09 am #Jason

    Rick,
    Housing additional cost = home loss of use = loss of home rental value.

    If you have a larger home, you should be compensated for that fact by having a similar property provided to you for your family’s use. If it costs more than the average family home, then it costs more. If you live in your owned cottage, you do so at your detriment that it cannot be rented out to others. If you wanted to live in your cottage and your burned home was available for rent, you could rent it. What rent could you receive on your home? for your cottage?

    If you don’t want your insurance company to pay additional living costs for housing, talk to them about paying you for loss of rental value for your home. It’s about negotiating the best deal for your family.

    ALE is the most vague coverage you have in your homeowner policy. I don’t care if your insurance company likes the quote for your cottage or not. If that is what you want, they don’t have anything else as a workable option for you and the policy doesn’t indicate they can refuse that option if it’s the one you want to exercise.

  1728. April 22nd, 2014 at 2:20 pm #Erin Armstrong

    I had a friend who file a cliam with his insurance company and the insurance compay the cliam, so he had his adjuster to write the check out to a friend of his is the money Lunding or is this fraud?

  1729. April 22nd, 2014 at 4:34 pm #Jason

    Erin,
    You are asking about money laundering and fraud. You don’t provide enough information about the situation for any analysis to be done.

    About your spelling, grammar, and attempt to communicate: I don’t know if your parents, schools, i-phone, teachers, or television are to blame for your writing skills.

  1730. April 24th, 2014 at 2:24 pm #Greg King

    Apologies if this isn’t the place for a new question.
    I bought a ranch home on a corner lot 13 years ago (if I knew then what I know now!) that has heavy wind damage to the roof on the west side. This isn’t something that happened due to any one defineable weather event but has happened progressively over the time I’ve lived here. The east side shingles are fine and good for another 10-ish years. There are 2 causes that I could account for this uneven again/damage:
    1) Here in SE Wisconsin everything to the west isnflat, e.g., The Plains. The wind cranks from the west year round so therefor the roof on that side takes a pounding more so than the east.
    2) Outside my property planted on the grassy parkway grass running the length of my property are very large trees planted by the city probably when the area was developed some 30 years ago. I’m not sure of the species but the one over the damaged part is very tall and hangs all over my roof. It drops seed every fall that I call ball bearings, and appears to exude some type of acid that has discolored and prematurely aged the shingles.

    I’ve made attempts to keep it trimmed but this sucker is tall and I can only reach the lower 20 ft. and the city has strict laws regulating treatment of trees. They used to take care of trimmng and replacement but as of 4 years ago require the adjacent homeowner to pay a certified arborist to do it. Hell with that! I have a chainsaw and we don’t like the tree anyway due to the slipping hazard the ball bearings represent on the sidewalk.
    As an aside, the base of that tree is lifting and heaving the sidewalk too which requires replacement of sidewalk slabs every 5 years or so; which the city charges me for!

    The city sidewalk supervisor told me flat out, when I complained and wanted my roof and stockade fence repaired or replaced that “It would be cheaper for you to just replace them yourself than take on the city legally.” No BS here…the man didn’t even blink when he said it.

    Homeowners (Kemper) insurance cops out and refuses to pay saying #1 the roof is too old (neighbor says it was just replaced before I moved in 13 years ago) and #2, it’s obviously suffered accelerated aging due to the acidic effects from the tree ‘sap’.

    I’m stuck! I haven’t called the Wisconsin Insurance Commisioners ofc yet because I like to research before opening my mouth.

    Thanks in advance! Love the site!
    Greg K
    Kenosha, WI

  1731. April 24th, 2014 at 8:25 pm #Jason

    Greg,
    Your homeowner policy requires a sudden and accidental incident in order to consider for any coverage by your policy. Since the weathering effect and the acidic residue from the tree are wear and tear conditions, your insurance has no event that they can consider for the condition of your roof (and fence). Accelerated aging from a tree is still considered wear and tear and that’s excluded in your policy.

    The city of Kenosha will not do a single thing for you. The supervisor gave you great advice. The advice is to get it fixed yourself and then try to recover it after you fix, and pay for, the problem yourself. Although this is beyond insurance advice, you will have absolutely no success in getting Kenosha to reimburse you for anything. Straight face or not, cities have no obligation to you for property you own. Further, the city does not protect you from plants or trees that frustrate you. The advice solves the problem while giving you a dead-end that you will eventually come to accept. The supervisor is doing his political job of lying but getting various improvements done at the expense of homeowners. He’s lied enough that he can make you believe it while not even blinking.

    Lastly, the insurance commissioner will do nothing for you. The commissioners main role is to make sure the insurance industry in his state is sound and financially stable. They take complaints to measure the “atmosphere” of the industry and to head-off any problems that might jeapordize the state’s insurance industry. It’s not true that the state insurance commissioner protects insurance customers because it only protects the overall state insurance industry for the continuance of their oversight office and his job.

  1732. April 26th, 2014 at 9:42 pm #Jason

    John,
    I am not aware of any valued policy laws regarding personal property. The valued policy laws are based on a dwelling used as a primary residence that is in effect totally destroyed. I don’t envision how that wording of a valued policy law can be applied to personal property.

    You may have stumbled upon something important with the Duckworth ruling. I’ve done a little research of that case and I don’t find any definitive answers. That case and how it may apply to your situation may need to be discussed with an attorney.

  1733. April 27th, 2014 at 6:09 pm #Pat

    i have a claim with nationwide in pa we had a really bad winter and my detached garage now has very bad bowing in the roof all four walls are bowing and the main support beam has snapped the adjuster came out and told me that she was very experienced in roofing and that it was caused by organic shingles and stated that it is in my policy that they do not cover building with organic shingles myself having working in the roofing field for about 5 years was able to proof that I have asphalt shingles and called and stated that with my agent and he had a meeting with adjuster when I finally herd back from her she told me it was denied because the damage didn’t happen instantly but there was snow on every roof in my area for weeks we just got back to back storms so once we agreed that was a bad reason now they are telling me it is lack of maintenance I had a contractor come and look at it and give me an estimate as directed by my agent and now they want to send a structural engineer out and I asked if it would be a third party company and was told yes because I was worried about getting a non bias report and it turns out it is a company that they use all over the u.s is this a conflict of interest since they do so much business with the insurance company also they inspected my property 2 years ago and wrote the policy they did give me notice that I had to replace all wiring in my house to keep coverage and I did within there 30 day window which cost me nearly 10k my issue is they wrote the policy and cash my checks but now I have an issue and they are just throwing everything at the wall excuse wise and seeing what sticks if there were any issues to my garage if I already spent 10k on my house don’t you think I would have made any necessary repairs to that building as well do I have any leg to stand on her or do I have to wait for the engineer company that from my research seems to be in bed with the insurance companies and is involved in multiple lawsuits about claims as we speak basically I want to know if you have any advice or encouraging words for me or should I just plan on spending money on a public adjuster my own engineer or should I just save all that money and give it to my lawyer as a retainer and go that route thanks ahead of time for any advice/ knowledge you may have just very frustrated

  1734. April 27th, 2014 at 7:54 pm #Jason

    Pat,
    If the roof and the walls on the detached garage are bowed, that condition developed over a period of time, especially the bowing of the walls. The amount of time may have been days, weeks, months, or longer.

    The policy you have covers sudden and unexpected/accidental damage. Your policy further explains that wear and tear are conditions specifically excluded.

    The engineer your insurance company is using will be biased for the insurance company. If an insurance company is paying the fees of the engineer, you and I both know the report is going to be in the favor of the party who pays their fees. Regardless of whether they are biased or not, they will apply their engineering credentials to the report and explain the detached garage’s condition and that the bowing roof and walls are technically not damaged as required by the policy.

    You have a main beam that you said snapped. That snapped beam should meet the requirement of the policy to be sudden and accidental, and the engineer report should indicate that. No one can doubt there was a lot of snow on the roof and the weight of snow likely caused that main beam to snap – unless the engineer finds that the broken beam was not a recent event.

    Your policy also has a specific coverage for collapse. I don’t know the severity of the bowing or that of the main beam but the policy considers a structure to be damaged only if the state of collapse is complete and the property cannot be used for its intended purpose.

    When all is said and done, your insurance company should pay for the cost to replace the broken main beam. Although I expect the engineer’s report will be biased, for them ignore that the weight of snow caused the main bean to crack would careless, unless it was an existing prior crack.

    If the insurance company doesn’t allow for coverage of the broken main beam’s replacement, then you have to determine the cost of the beam replacement and compare that to suing to compel the insurance company to cover the broken beam. The cost of replacing the beam will likely be less than the cost of suing the insurance company.

    A public adjuster may be able to assist you to get as much coverage surrounding that broken main beam as possible if that break was the result of this winter’s snow load.

  1735. April 30th, 2014 at 1:31 pm #Dora

    Hi, We have a homeowners policy with andover in NJ. standard ho-3 policy with water back up and sub pump endorsement. Two abutting retaining walls on our property collapsed onto our neighbors property one evening. It did rain that evening but there was no storm or flood.
    First question is whether this type of claim is covered. it seems that the language in the policy is quite ambiguous. drainage is required in order for water damage to be covered under our additional endorsement. but underground water problems are not? it appears that the collapse was due to rain, perhaps drainage issue but not storm or flood and we are on the cliffs so it was regular ground run off water that runs from property to property.
    Second question concerns timing. We are now 32 days past our claim having been filed with our agent. We received notice from an independent adjuster confirming the claim. They came to view the property. He called me and said that he needed to send a structural engineer b/c he did not feel he was equipped to decide as to cause of collapse. he said the structural engineer would contact me to view the damage. Nobody ever did. No word from insurer. Isnt there a 30 day period in which they must pay/deny? What is my recourse here?
    Third question is do I have a bad faith claim.

  1736. April 30th, 2014 at 2:09 pm #Jason

    Dora,
    Depending on what caused your retaining wall to fall, it is difficult to determine if it will be covered. The cause of its collapse is key.

    Some language surrounding retaining walls and a number of causes is below:

    3) Freezing, Thawing, Pressure, Or Weight Of Ice Or Water — “We” do not pay for loss caused by freezing, thawing, pressure, or weight of ice or water, whether driven by wind or not, to: …
    c) bulkheads or retaining walls that do not support all or part of a building or other structure;

    The Collapse coverage of a standard policy contains this wording:
    However, “we” do not pay for loss to awnings, bulkheads, cesspools, decks, docks, drains, fences, flues, foundations, patios, paved areas, piers, retaining walls, septic tanks, swimming pools, underground pipes, or wharves caused by a peril described in 2) through 6) above unless the loss is the direct result of the collapse of a building.

    There are limited causes of loss that can apply to a retaining wall and include fire, wind/hail, explosion, vehicles, vandalism, and a few other ones – but only if a part of a building was involved in the retaining wall collapse. Additionally, coverage may result if damaged was due to insect, rodent, or “vermin” damage – AND – under certain circumstances.

    Answer to 1. Generally retaining walls have enough exclusions that it is rare an insurance company has to pay for its damage. Coverage based on the information you provided seems very unlikely.

    Answer to 2. I think the adjuster did the right thing by requesting an engineer. The adjuster likely found that no coverage exists for the retaining wall and figured an engineer was needed to confirm or refute that determination. No, there is no rule or law that claims need to be resolved in a certain amount of time. Call the insurance company and ask your adjuster when the engineer will look at the retaining wall.

    Answer to 3. Absolutely not. You don’t have a bad faith claim. A legitimate bad faith claim may result in every 1 million claims (rough guess). Proving bad faith is a nearly impossible burden even when it occurs. It did not occur in your claim – not even close.

  1737. May 5th, 2014 at 11:40 am #Trevor Stutsman

    After a house fire destroyed my mothers house there are a number of items that were my fathers who is no longer living that were destroyed. Personnel items that she has no use in replacing yet there is a recoverable depreciation amount that is still owed to her. Does the Insurance company pay any money from depreciated recoverable funds on items that are not replaced? Is there a settlement made after the house is rebuilt if there are still funds remaining?

  1738. May 5th, 2014 at 1:12 pm #Ron Meyer

    The insurance company says that my vinyl fence is only covered at actual cash value. Is that true

  1739. May 5th, 2014 at 1:59 pm #Jason

    Trevor,
    The personal property needs to be replaced in order to collect the recoverable depreciation of each item.

  1740. May 5th, 2014 at 4:24 pm #Jason

    Ron,
    That is true. Basically any structure that is not a building is covered and settled at ACV.

  1741. May 8th, 2014 at 11:04 am #Ricardo

    I have a HO3 policy with NJM insurance. I placed a claim for water damage to my basement but I was denied.

    There was a severe storm which 6 plus inches of rain fell within a 24 hour period. Due to unknown reasons, water collected in the window well and busted the window open, caused water to enter the basement. Is there anyways this would be a covered claim due to the faulty window.

  1742. May 8th, 2014 at 11:34 am #Jason

    Ricardo,
    Except for specified flood insurance policies, nearly every single homeowner policy excludes water at or below ground level.

    It would be ideal to be able to blame someone or something for water damage in your basement. You can’t successfully blame the window because the window did exactly as it should when it there a large accumulation of water in the window well – it broke. This is expected of windows.

  1743. May 12th, 2014 at 9:11 pm #michelle

    I have national general homeowners insurance underwritten by homesite insurance of the Midwest. I live in Newburgh in. last week we had a macro burst (not tornado) with winds up to 120mph. we sustained damage from several of our 60 + ft maple trees to our roof, inground pool, fence, fishing boat and trailer. 2 questions ….#1 our insurance company says it will only allow $500 for the removal of trees (we will need a crane for removal of tree on our house) anyway to get more money for removal? I think the 500 would probably only cover 1 branch. #2….they say the boat is not covered (its on a trailer and licensed). isn’t that considered personal property, and how can we recover it? it is worth est. $3800. thank you

  1744. May 12th, 2014 at 9:21 pm #Jason

    michelle,
    $500 is for tree debris removal/disposal. The cost of taking the tree limbs off your house and dropping them to the ground is part of the cost of repairs to your home. The $500 limit doesn’t start until the tree limbs are completely removed from your home. Take advantage of this policy coverage part.

    Boats need their own coverage. A typical homeowner policy will exclude things such as cars, planes, and boats unless you specifically add those to your policy. Your homeowner policy provides limited coverage for trailers if they are damaged. You would have to review your policy to see what coverage applies to trailers.

  1745. May 13th, 2014 at 5:27 am #michelle

    thank for your prompt and informative response

  1746. May 13th, 2014 at 7:00 am #michelle

    sorry to bother you again but 1 more question….will the insurance company pay to have trees removed from our pool so the contractors can replace the pool ?

  1747. May 13th, 2014 at 7:27 am #Jason

    michelle,
    Tree removal on covered structures like your pool should be handled similar to the way tree removal is covered for your house.

  1748. May 13th, 2014 at 7:58 am #michelle

    thanks again 🙂

  1749. May 14th, 2014 at 8:15 am #Michelle

    Hello,

    I live in Atlanta, Georgia and had some damage to my townhome in February. The damage was done by a former boyfriend during a fight. He put holes in my walls, threw things into my hardwood floors, and ruined all of my electronics. I filed a police report and insurance claim. The claim process was very easy and my insurance adjuster was AWESOME. He came out quickly and processed my claim within the same week.

    My hardwood floors were scratched up in a few areas during the altercation, but I never dreamed that they would need to be totally replaced. My adjuster put a total floor replacement in my claim and this was approved. The total claim was around $9500. This includes the floors, walls, and a door that was damaged.

    I was able to get a friend of mine to repair my walls and door for very cheap. I didn’t even have to buy materials because he had some leftover from a home that he was working on.

    The issue that I have is with the floors. The floors were not damaged severely and really only needed to be refinished. I have a huge 70 pound English Bulldog and he occasionally scratches the floor. I can’t see replacing the entire floor when I have a young dog that is huge. Therefore, I repaired the few boards that were heavily scratched and had the floor refinished for about $1000. However, the insurance money that was allotted to this repair was $5702. My mortgage company released $2500 of the money to me to start repairs and I made those repairs. They are holding about $3200 of the money in an escrow account.

    My mortgage company informed me that they will not release the additional funds to me until I have a home inspection and produce receipts/invoices to them. The only receipt that I have is for the floor refinishing and some paint that I bought.

    Will my mortgage company refuse to release the final funds because I didn’t replace the entire floor? What happens to the money that’s leftover after repairs?

    I have a home inspector coming tomorrow and I’m really nervous that there will be an issue regarding the floor. The policy states that I have to restore my home to pre-incident condition. I did that because after the refinish, my floors are glossy and look brand new.

    Thank you,
    Michelle

  1750. May 14th, 2014 at 12:12 pm #Jason

    Michelle,
    It’s really a mortgage concern you have – not an insurance issue.

    You will have to rely on the inspector to confirm the repairs are fully completed. Hopefully that will be enough for the mortgage holder. The inspector report may also be enough documentation for your insurance company to release the recoverable depreciation ($9500 – $5700 = $3800) to you.

  1751. May 14th, 2014 at 5:51 pm #alex ruden

    hello, daughter in northern virginia had dishwasher water explosion. damaged first floor. adjuster came today 5 14. said saw mold that must have caused the event. claim denied. state farm. your thoughts appreciated. thanks, alex

  1752. May 14th, 2014 at 5:58 pm #Jason

    alex,
    The transfer of information from your daughter, to you, then to this site doesn’t seem very accurate. Water explosion and mold causing the explosion doesn’t compute. I don’t have anything to add because my output won’t be reliable with inaccurate information.

  1753. May 15th, 2014 at 8:16 pm #wondering

    Live in indiana and have nationAl general home insurance. After a wind storm we were left with a
    lots of oak trees in my above ground pool which destroyed it. If we decide not to get a new one can we keep the. Money

  1754. May 15th, 2014 at 8:21 pm #Jason

    wondering,
    The money paid to you after an insurance loss is to replace the property you lost. If you decide not to replace the damaged property, that is your choice. If you elect to just keep the money instead, that is also your choice. What you do with insurance the money is up to you.

  1755. May 20th, 2014 at 1:31 pm #JoAnn

    Hi, our entire town was badly damaged by a tornado here in Nebraska. Many of us have the same insurance carrier, Farmers Mutual, and no one is very happy with them. I know we are all anxious and just trying to get enough money in to keep going, but I want to make sure I get all the money I’m entitled to.
    My policy is ACV, but replacement cost on contents. My dwelling is insured for $124K and $12.5K for other structures. Our only “other structure” is our garage, which was lost completely in the tornado. So will we get the entire $12.5K for that part of the loss then?
    They said they will depreciate our roof and give us a number (which we haven’t gotten yet), but that they will not depreciate our paint much and will just pay the contractor directly for the other repairs to the property, excluding the roof. This is a contractor our adjuster recommended.

    We gave the adjuster a list of lost contents from the garage, and an estimate of their worth of $4900, he said if we found other items that were lost to just make a list and send it to him. Well, when we went upstairs we found that our childrens’ room was covered, wall to wall in broken glass. So everything in the room has to be replaced, all the mattresses, toys, clothes, and carpeting. I sent over an updated list with an estimate of what they will cost to replace and he asked me for information on where they were purchased and for how much. Well, how would I know that? Why is he asking for that if I have replacement cost coverage on contents?

    Thanks so much for your help.

  1756. May 20th, 2014 at 1:47 pm #Jason

    JoAnn,
    You probably will be paid the ACV for the garage. I don’t know what that will be. It’s basically the cost of a new garage less depreciation.

    The adjuster wants a list of things with the approximate retail price (before tax) so he can establish a baseline for your personal property claim. For the personal property, you will be paid its ACV and as you replace the items, you can ask for the difference between the replacement cost and the ACV that they held as recoverable depreciation.

    I don’t think the place where each item was purchased is that important.

  1757. May 21st, 2014 at 7:54 am #JoAnn

    Thank you for your help!

  1758. May 26th, 2014 at 8:20 pm #Liliya

    Hello,

    I hope you will be able to help me out. I recently purchased a condo in a 8 unit condominium. I found out later that the walkway is falling apart and needs to be redone ASAP (someone called the City of Austin and we were warned to do this right away or else). We had an engineer come out and do an estimate of what caused it and what needs to be repaired (he stated that it was due to bad design and poor construction). We had a couple of bits come from contactors, which are in $150K range. Based on that, each unit owner has to come up with their portion (there is nothing in reserve and no one will give a loan to our condo because of such large sum and only 8 units). I would have assumed this should be covered by our homeowners insurance. I filed a claim and the adjuster came out, but said that if it is due to poor construction, it might not be covered. This building was originally turned into condo sometime in mid 80s, the construction company is no longer in business, so we can’t get them to fix this. Is there any other way to make this claim to the insurance company to cover the repair? I pretty much have no choice, I can’t cover my portion and can’t even get another loan because I just got a mortgage. Any advice would be greatly appreciated.

  1759. May 26th, 2014 at 9:28 pm #Jason

    Liliya,
    In reviewing the limited coverage from the loss assessment coverage of a standard condo policy, the payment of up to $1000 for an assessment to the unit owners needs to be due to a loss that would be covered by your policy. Since it’s not due to a covered loss but rather poor construction, there is nothing your insurance can do for you.

  1760. May 26th, 2014 at 9:55 pm #Liliya

    I am a bit confused, if they don’t cover wear and tear and poor construction, what kind of cause they do cover(since they do list walkways to be covered)? I read 100 page policy and didn’t see anything stating that (unless there are known exclusions that apply to all homeowner’s insurance). If we can go after the original construction company, shouldn’t there be something in the insurance that covers the cost with deductibles (kind of like car insurance). We obtain this insurance much later after this was build, didn’t they come out to inspect the property and should have noticed that, so in a way they insured a poorly build walkway and should pay for it to be fixed. I am just trying to find any way to save my condo or I will loose it since I am unable to make over $20K assessment. If I knew about this, I would have never purchased this, sucks to find out about it a month after you purchase it and already put in all your money into it.

  1761. May 26th, 2014 at 10:29 pm #Jason

    Liliya,
    Insurance provides coverage for things that are sudden and accidental like fire, tornadoe, etc. The policy basically covers everything that is not otherwise excluded. Improper construction is an excluded cause.

    I doubt you will have any luck with an out of business construction company that did the construction.

    An insurance company looking at your property does not make them responsible to pay for an excluded item. Instead, the collective owners should have done due diligence prior to purchasing. As owners, you will always have maintenance and upkeep to do on the property.

    In order to plan and prepare, the other owners and you should set up a reserve for future upkeep and maintenance.

  1762. May 28th, 2014 at 6:44 am #tabitha

    I recently had a homeowners claim denied after a freeze-up, the home was unoccupied due to my parents recent deaths. In spite of my frequent visits there to work ( I live 16 miles away), the insurer has refused to pay and their findings are mostly based upon an engineers report (fuel gauge analysis) which alleges that I could not have had the heat on,etc. although all of the evidence contradicts this fact. My question has to do with this supposed ‘expert’ who arrived with a flashlight and a camera, I have heard this referred to as a ‘bogus science’ at best and the insurance companies use these people with the intention of denying claims, especially on second homes or otherwise unoccupied homes. I can find nothing on the internet to help me find whether this ‘science’ is refutable and can’t afford to hire my own engineer even if I could find one. I welcome any advice. Thank you!

  1763. May 28th, 2014 at 5:52 pm #Jason

    tabitha,
    Visits to your home don’t constitute occupation no matter what. It doesn’t matter if you were 1600 miles away or 1 mile away – if you didn’t occupy your home during a period of time in which your pipes froze and broke, there isn’t coverage. I don’t know to what you refer when you say ‘bogus science’ because fuel gage and energy usage compared to exterior weather temperatures can be established with a high degree of accuracy. Engineer’s base their findings on facts, not fabrications.

    In your first sentence you said your home was unoccupied. When you confirm that, I think the insurance company got it right.

  1764. May 29th, 2014 at 3:26 pm #Tylene

    We had a couple bad storms in a row with really high winds, we lost a lot of shingles in all areas of our roof. We had an adjuster come out and he told us that we had a bad contracting job, so he only took pictures of some of the damages because if he took pictures of all of it his supervisor wouldnt let him file a claim for us. We thought this was generous, he priced out everything fairly high. He also gave us about 3 main reasons as to why it was a bad contracting job. We told this to a contractor and a few others that have done roofing before, including a family memeber who is a contractor.
    1. the adhesive on the back of the shingles weren’t peeled off and used correctly
    – everyone told us that isnt even how you roof, the adhesive is there for i.d numbers and thats it.
    2. the percentage of air used to nail in the shingles was low.. (14 year old roof)
    – we were told that is being VERY picky on “bad contracting” because the nails could have been pulled up by the air flow due to the missing shingles
    3. our valley is crooked.
    – we were told that if it were a bad contracting job and the valley is crooked we would have gaps in the shingles and we would be getting water damage, they also went up and looked and said that yes, the valley has a curve to it but every shingle is placed correctly even with the curve and that it shouldnt be a reason our insurance wouldnt cover us.
    Especially because the reason we called was because of wind and storm damage and that is why we lost shingles…. some of the shingles arent even near the valley for that to be a reason for bad contracting

    We called for another adjuster, our agent was happy to send another out.
    My boyfriend got a call from the manager of all the adjusters who basically told him based on the report the money our adjuster gave us was generous.. when our adjuster told us he didnt even take pictures of all the damages or we wouldnt be covered.. how would this manager know if it was generous unless he came out and looked himself or sent another adjuster out? he basically just told us we got what we got and got off the phone. Not even concerned about any of the information we told him

    It confuses me as to why he would hear everything we told him and he not be concerned.. being the manager.. so i am afraid our insurance company is trying to save money and doesnt care about us. It could also truly be a bad contracting job.. but we have no papers showing us what dictates that.. just the word of an adjuster.. not even 2 adjusters or paper work telling us what dictates bad contracting.. we didnt get that privilege. I would have called him back myself and told him to get someone out here but i dont want another person who obviously doesnt want to help us out there again.. what do i do from here? A contractor told us to call him when the adjuster comes out and he would make sure that the adjuster knew what he was talking about is that our best bet? Will our agent care about any of this if i call her back again?

  1765. June 3rd, 2014 at 10:22 pm #April

    We have had a pipe break in our kitchen… we had to have the floor jack hammered to get to the pipes to be repaired/replaced. The abatement people came and removed our cabinets, and countertops in order to gain access to the floor to get the the pipes. The abatement company broke our granite counter tops when removing them and then just threw it away??? Now our insurance is saying they will not cover it? They are also saying that they will not replace the viynel flooring either… as it was scratched up and had cement on them as well as a hole in it due to the workers coming in and our and dragging their tools etc all along them. They also just threw my sink and faucet out the door onto the cement as well as leave my cabinets outside in the sun to ruin. Why are these things not “covered”? Do I just have horrible insurance?

  1766. June 4th, 2014 at 5:40 am #f m conte

    Hi April,
    It appears as though the damage you described was done by contractor negligence, this is not something your insurer will pay.
    I would attempt to file a claim with the contractors insurance, and perhaps consult an attorney.

    FM CONTE

  1767. June 5th, 2014 at 9:28 pm #Jason

    Homeowner policies protect your home for sudden and accidental damage from causes of loss that are outlined in your policy. Fire, a tree falling on your home, hail, and vandalizm are covered causes of loss. If your home develops cracks in its walls, or water enters your home at or below ground level, it will not be covered (unless you have water backup and sewer overflow coverage). Insurance doesn’t cover everything and you need to know what kind of coverage you have. In summary, your policy covers everything that happens to your home unless the cause is excluded. Review your policy to gain an undeterstanding so you are not suprised when you have a loss.

    Also, there are good insurance companies and not so good insurance companies. You want to have a good insurance company when the need arises. To review your insurance company rating, see Best and Worst Insurance Companies at the top of this page. If your company is not ranked very high, you need to make a change immediately.

  1768. June 6th, 2014 at 3:16 pm #Philp

    My client owns a home that is rented out. His tenant had a roommate living there without my clients permission. The roommate caused a vandalism claim and the claim was denied because the company considered the roommate as a resident. Is the roommate considered a resident?

  1769. June 6th, 2014 at 3:59 pm #Jason

    Philp,
    I would have to accept the insurance company’s assertion that the roommate is a resident. Residents cannot technically damage property they rent. The only thing that people who live in a rental can cause is extreme wear and tear. Because there is a lease between the landlord and the tenants, the wear and tear can appear as vandalism but the rental contract allows the tenants to use the place as their own and that sometimes includes severe wear and tear.

    The landlord probably collected a deposit for excessive wear and tear.

  1770. June 7th, 2014 at 6:22 pm #Barbara Stricker

    My friend just told me that if my house burns down and, even tho’ I do have fire insurance, I won’t be able to collect if my house doesn’t have its ‘final’. True?? False (oh how I hope).

  1771. June 8th, 2014 at 10:29 am #Robin

    In the case of a bathroom that had a leak and caused mold damage, the tile was very old, and cannot be matched. It was removed in several places but since it cannot be matched, is the insurance company obliged to tile the main part of the bathroom, minus the shower and toilet area?

  1772. June 8th, 2014 at 10:37 am #Jason

    Barbara,
    When you mention final, that is meaningless to me. Final inspection? I will assume you mean before your home is issued a certificated of completion. A certificate of completion’s absense or existence for a property doesn’t mean the property doesn’t have any value, or can’t sustain a loss, so I don’t know where your friend came up with his/her information.

    New homes under construction have different coverages and exclusions that apply. Your agent is the best source to get information that applies to your specific property.

  1773. June 8th, 2014 at 10:44 am #Robin C

    I had a broken pipe in the bathroom that over time seeped into the wall and finally showed water in the bathroom floor. By that time it included mold and so I turned in an insurance claim. The insurance company is clearly not interested in making this a priority but my question is are they required to tile the entire bathroom minus shower and toilet if the tile, which is approximately 17 years old cannot be matched?

    Thanks;
    Robin

  1774. June 8th, 2014 at 10:47 am #Jason

    Robin,
    You’re getting ahead of yourself. A water leak that has been leaking for a long period of time may not even be covered – especially if it occurred for a duration long enough to produce mold.

    Policies cover direct damage only. Each claim or damaged area is different and the insurance company’s goal is to repair the direct damage. Sometimes it will require replacement of undamaged items that are continous to the area that was damaged. Policies have no coverage for matching concerns.

  1775. June 8th, 2014 at 10:53 am #Barbara Stricker

    Thank you Jason. “Final” is the word that people here in Plumas County use, even the planning department calls it that but, yes, it probably is a ‘certificate of completion’. Back when I built my home, in 1980, you didn’t have to have that certificate to move in and since that was true at the time, I never bothered to get one. I know that will be a problem if I ever decide to sell but, as the land is my Mom’s and I only built here to take care of her, I never worried about that certificate. And then yesterday my friend told me if my house burned down the insurance company might not pay due to a lack of that certificate… this is California and I live in a forested area, so a fire is not a remote or unusual event. Again: Thank you for taking the time to respond.

  1776. June 8th, 2014 at 11:17 am #Jason

    Your home is old enough, including the fact that you have lived in it the entire time, that it has an assumed COC. What your friend told you is incorrect.

  1777. June 10th, 2014 at 11:06 am #Brian

    I’ve got a weird situation and I’m not sure how to react. It has to do with marketable value vs. insured value. I’ve never made a HO3 claim.

    I have an HO3 policy with a lesser-known company. The dwelling limit is for ~1.3M. In 2008, when I started with them, that seemed reasonable – we’d just finished a large construction project and given purchase price (2002), (boom) appreciation 1.3M seemed right/ok. The insurer did a walk-thru appraisal.

    Last year I refi’d. Paid the bank for an appraisal. That came in at ~765K. I didn’t expect 1.3m — but I really didn’t expect anything less than 900K. There were some issues with the comparables and I assume appraisers for banks wink,wink at low-ball appraisals.

    I spoke to, and receved a quote for the same property from a large national insurer who holds my car policies. They did a walk around appraisal —
    that came in at ~865K.

    So what’s right? We don’t have a house full of artwork, expensive furniture etc. A friend realtor said that 850-900 is probably right. It hurts but it is what it is.

    There’s no way the house would sell in this neighborhood for >1M.

    Say we have a 200K in posessions so the insurer says the house will take 1.1M to rebuild in a total loss. If I was a home buyer looking at the house –shouldn’t I recognize
    that the house is way underpriced at $900? Rather than paying abuilder to build me the same house for 1.1M. That is a very inefficient market.

    So, the house is overinsured? yes? How do I cajole/coerce my current insurer to lower the dwelling limit?
    I’m a little leery of lowering my limit down to 865 — with an insurer of arguably dubious claim paying history — On the other hand
    I don’t want to be overinsured. I asked the new company for a bump in dwelling to 1.0M that policy is ~40% less premium than the current
    co’s 1.3M.

    thanks

  1778. June 10th, 2014 at 12:04 pm #brian

    oops! Sorry! I forgot “personal property” in a HO3 are separate covered item from the dwelling limits.

  1779. June 10th, 2014 at 12:09 pm #f micheal conte

    We often see rebuilding costs exceed market value in today’s economy, that is not a surprise. Engage a builder and find out what the current rebuilding is and insure for that?

  1780. June 10th, 2014 at 12:46 pm #Lisa

    My neighbor has been out of her house for over a year due to a fire. Her house is paid off and, while it took a very long time, she has started to receive some money from her insurance company and has been able to at least get a new roof. But she still doesn’t have enough to finish the rest of the house.

    She hired a public adjuster who seems to be holding on to a large check from her insurance company. She is a single, out-of-work parent who has been living in a weekly rental hotel with her 11 year-old son and dog. The state has basically told her that she needs to hire an attorney to sue the public adjuster. She has no more money left and can’t possibly hire an attorney.

    Any advice would be greatly appreciated. Thank you.

  1781. June 10th, 2014 at 5:17 pm #iasbel

    con someone please help answer this question ….. I have insurance with citizens my policy was sold out to Olympus but now I have to file a claim. if I file Olympus will cover it but am I then obligated to stay with Olympus there premium is really high and I cant afford it…..

  1782. June 10th, 2014 at 6:09 pm #bary

    Our homeowner’s insurance wants to exclude our dogs from coverage, that’s the only way they will renew our policy. This is because of a claim that’s still open for the last 10 months. They couldn’t settle because the other party is lying and want to take advantage of the insurance as much as possible. Anyway, if I shop around for homeowner’s insurance , would anybody accept us with an open claim showing up in CLUE or similar? Is it worth trying? Or are we stuck with our current company till they resolve this claim? which can be a long time? If we allow them to exclude our dogs, does this mean we are accepting fault, or does it mean we can never get home insurance with any other company that would include our dogs? thank you

  1783. June 10th, 2014 at 10:01 pm #Jason

    Brian,
    Talk to an agent about your concerns. They should be able to explain it to you. If you live in a valued policy state, you want to have your home insured for more than its fair market value. (Look up valued policy states). If you want to keep your premium low and don’t live in a valued policy state, keep your insurance levels as low as you can comfortably feel.

  1784. June 10th, 2014 at 10:05 pm #Jason

    Lisa,
    Don’t get involved in the drama and problems of your neighbor. Focus on your family and don’t become distracted with problems that are not your own.

  1785. June 10th, 2014 at 10:07 pm #Jason

    iasbel,
    You can choose any company you want to be your insurance company.

  1786. June 10th, 2014 at 10:13 pm #Jason

    bary,
    You won’t know who will or won’t accept the risk you and your dogs present until you shop around.

    If you have no concerns about your dogs, then exclude them. If you have concerns, then that lends credibility to the claimant who has made a claim against your policy.

    If you agree to exclude your dogs, it doesn’t mean you accept fault, it just means that you are o.k. that you accept all risk associated with your dogs and the insurance company accepts zero risk for the dogs.

  1787. June 11th, 2014 at 9:23 am #Sandy

    On May 12 2014 the city I live in had the sewers back up. I called my home owners that night and was told I was covered. The representative gave me a claim number, instructions of who to call for their cleaning services, and told me my adjusters name and phone number. The representative told me if my home was uninhabitable to go stay in a hotel and to say my receipt so I would be reimbursed. I called their cleaning company that night.
    On May 13th I played phone tag with my adjuster to no avail of actually speaking to him.
    On May 14th I called my adjuster in the morning and left a message to no return call that day. The cleaning company came out and did their job of ripping out carpet and drywall in my lower level.
    May 15th my adjuster called me and we actually spoke and that is when he informed me there was no coverage in my policy for anything that happened. When I asked why they told me I was covered on May 12th he said they never told me that. I was so irrate. I asked for a copy of the phone call that was had on May 12th and was told because of privacy laws they would not be able to provide that for me. What do I do? There is now a bill from the cleaning company that would no exist had they not told me I was covered.

  1788. June 11th, 2014 at 11:21 pm #Jim

    It has been nearly 4 months since our house fire in Georgia and the insurance company has not yet sent us a Statement or Letter of Intent. Is there a time limit for this? I think I read somewhere that they were to send this within 2 months, but can’t remember. Are they in violation of any laws by not sending this?

  1789. June 12th, 2014 at 5:05 am #Jason

    Jim,
    Your insurance company wants to settle your claim with you as soon as possible, just like you want to settle as soon as possible. You wouldn’t quickly settle your claim if the offer was much lower than it should be. Insurance companies need to appropriately investigate a claim to determine, 1. If they owe the claimed amount, and 2. How much to pay if they determine an amount is owed. There is no time limit for this to occur. There are no laws being violated by taking as much time as it’s taking.

  1790. June 12th, 2014 at 7:27 am #Shirl

    We had a fire in January where the whole row of homes were burned. the insurance company paid content reimbursement and dwelling reimbursement. My mother died in March and was the sole owner of the home. Her will left the house to me and my brother. But there are 2 other children and they want 1/4 of the money which was deposited in my mothers account after she died. Are they entitled to any of this money? They did not reside in the home with my mother, only me and my brother and nephew lived there. the insurance company has provided living accommodations for the residents.

  1791. June 12th, 2014 at 3:15 pm #Jason

    Shirl,
    Your question is not about insurance – it’s about the interpretation of a will. You may want to discuss with an attorney.

  1792. June 17th, 2014 at 9:06 pm #Susan Desmarais

    My rental property was destroyed by fire; I own it outright. Can I take the cash from the insurance settlement or am I required to rebuild? Will I receive the full settlement if I opt to cash out?

  1793. June 17th, 2014 at 10:30 pm #Jason

    Susan,
    If you have a typical insurance policy, you will be paid the ACV value of the damage. If you rebuild, you will receive the ACV portion and upon completion you will get the amount applied as depreciation.

  1794. June 18th, 2014 at 6:46 am #Andy

    My shed has smoke damage due to my tractor battery cough fire. My policy says I have 100% replacement but they want to clean it and paint the whole inside of the shed. What are my options? Can i insist on replacing the shed or do I have to go with there recommendations? Tractor is a complete loss as is some other small power tools.

  1795. June 18th, 2014 at 8:58 am #Jason

    Andy,
    Your options do not include replacing a shed when the smoke didn’t structurally damage the shed. What you have is paint damage. The insurance will replace the paint (after cleaning) it. That is what we call replacement.

    Your damaged power tools are elgible for replacement.

  1796. June 19th, 2014 at 11:34 am #Tiffany

    Hi. My grandfather passed away a few years back and his home (which is paid in full) was left to 4 heirs/siblings, one of which is still living in the home. The sibling currently living in the home has insurance on the home, but only him being named the insured (not all 4 siblings).

    The home recently caught fire and a claim was made with the insurance company. The insurance company recently made payment for the personal property claim and also the money for repairs.

    However, it was not made payable to ALL 4 owners of the property, rather only the one living in the home and who was the insured.

    Question… should the payment have been made to ALL 4 owners of the property?

  1797. June 20th, 2014 at 8:24 pm #Jason

    Tiffany,
    No, the insurance is an agreement between the insured and the insurance company. Since 3 owners are not party to the insurance contract, there is no way that they would be listed on the check. If you want to be insured as far as the home, get your own policy or join the policy with your brother.

  1798. June 24th, 2014 at 10:24 am #Denise

    Public adjuster from HELL!!!! He inspected our house and made a claim with our insurance company. Months and months with no word from him we were always told he was waiting for our insurance company to get back to him….finally our insurance company and him met then that was it we have not heard anything for awhile…..low and behold we found out he had a check for 7 months and it was cashed!!!!! Finally he gave us a check which bounced but finally made good on it. Then we find out he got another check and cashed that one at first he said that is not our check that it is for his contractors ….he is now claiming that is not our money because we need reciepts…everyday it’s a different excuse he always says he his coming over and never shows up. How do we resolve this matter? When we hire a lawyer will he be responsible for our lawyer fees if guilty?

  1799. June 24th, 2014 at 2:50 pm #Jason

    Denise,
    Although you entered into a contract with someone for your insurance issues, your concerns are not insurance related. Instead they are related to a contract you entered with another person.

    As for attorney fees, there is no guarantee the judge will have him cover your fees.

  1800. June 26th, 2014 at 7:18 pm #melody

    hello I am in the middle of remodeling my friends pool. He has in the time had the insurance company drop him on there insurance for the house. Cause was that he was not living at the house physically. He is and they wanted to come during working hours and so he has to change companies, we are niot done and in the middle of the project. what can effect the policy and what do I do to keep the pmnts low and everything legite please tell me .

  1801. June 28th, 2014 at 4:17 pm #Jason

    You do not own your friends house so you have no interest in getting insurance protection for it. If I didn’t address your concern, repost again with information that makes more sense.

  1802. July 1st, 2014 at 9:24 am #Marie

    Hi,

    In December there was a huge snowstorm and the pipes all ended up freezing/bursting. The house flooded and the next door neighbor ended up seeing the water coming from the basement window and calling the police/fire department. Our family was just about to move in that week. The adjuster came took photos and then got back to us asking us for bills. We gave everything in but it’s been six month and we have not heard back. Finally, my mother goes to the agency to figure out what’s been happening and got told the claim was close due to lack of communication. Each time they had called to speak with my mother, she asked for a translator because she does not speak english very well. The representative told her he’d call back since they had to find someone. They’ve also said they mailed a letter to her but she never received it. Work has already been started in the house and she’s been paying for a huge part of it. Would you happen to know how to go about re-opening the claim? Also, her agency said that even if re-open they might not cover the damage. I’m currently trying to find out more as to why they wouldn’t cover it.

  1803. July 1st, 2014 at 7:27 pm #Jason

    Marie,
    I would have concern that no one was living in the home and the pipes were not winterized. You didn’t explain how the pipes froze if there was heat maintained in the home. I can’t offer you any information with the limited information you provided.

  1804. July 7th, 2014 at 7:41 pm #Andrew Hale

    We had a fire back in September and our home was deemed a total loss. We have a Guaranteed Replacement Cost policy in which we have been paid the ACV already.

    We chose to relocate instead of rebuild and purchased a home for an amount greater than the ACV and without dispute the Insurance company has agreed to pay us the difference between the purchase price of the home and the ACV in recoverable depreciation.

    However, and we anticipated this, the insurance company intends on subtracting the value of the land from the recoverable depreciation check they are going to send us.

    The Warranty Deed we received at closing states we paid a nominal amount of money for the described parcel of land; $1.00.

    There is no other dollar amount in the real estate contract or the closing paperwork for the value of the land.

    The one dollar amount is what we used in our calculations of the cost of the home minus the cost of the land for our recoverable depreciation.

    Do you foresee any problems with this?

    Thanks in advance.

  1805. July 7th, 2014 at 8:50 pm #Jason

    Andrew,
    It doesn’t matter if you used a $1 for the cost of the land. It also doesn’t matter if you accounted for the cost of the land to be $1, or that you expected others to be fooled by the deflated land value. What matters is the actual market value of the land. Since insurance excludes the land on which your property rests, land isn’t something that is covered or payable by insurance. You still have your land associated with your damaged home. That land remains yours until you sell it. Did, or will, you sell it for a $1 ?

    I believe you even knew land would be subtracted from your settlement check because of your move to allocate more to the house and a tiny amount for the land.

    I see no problems because the insurance company is dead-on accurate about what they are doing.

  1806. July 7th, 2014 at 10:53 pm #Andrew

    Jason,

    I did not set the value of the land in the warranty deed. The title company did. I came across that dollar amount in the paperwork when looking for other information a few weeks after the closing.

    You assume I’m scheming here when I am simply asking if I was right to use the number the title company said I paid for the land.

    I’m not trying to fool anyone, but if the warranty title is an incorrect number regarding what I paid for the land, and county tax records are only percentages and approximations, where will the correct value come from?

    There was no appraisal done because no mortgage was taken out.

    We moved into a very small sub-division in a rural area with virtually no other homes or residential land for sale, so getting an accurate market value will be very difficult.

    You mentioned our land where our home burned down. Would it be acceptable to deduct the same value we are selling our land for at our burned down property from the recoverable depreciation?

  1807. July 8th, 2014 at 5:07 am #Jason

    Andrew,
    It doesn’t matter who placed the $1 valuation on the land. Everybody, including you and I know that $1 does not represent the market value of the land.

    Please don’t assume that I’m assuming your scheming. I don’t assume. I may draw incorrect conclusions if provided with inaccurate information. Right or wrong about using the $1 valuation is neither – instead it will be disregarded and an accurate market valuation of the land will be used.

    I don’t know how the insurance company will determine an accurate and fair land valuation, but they will. Perhaps an appraiser will assist with that.

    It doesn’t matter if there are not many current properties or land available in your area. If needed, the area will be expanded until there are enough current properties or land for sale. They will also rely on historic sales of properties and land.

    The land associated with your burned home: No, that land has nothing to do with your replacement property and the land the new property sits upon. The insurance company will pay to replace your home. If you want to replace it at another location, you need to pay for the land. The insurance won’t even consider it.

  1808. July 10th, 2014 at 1:41 pm #Marian

    Hello,

    We had a major hailstorm that damaged all of the homes and vehicles in our neighborhood – ours being one of the worst because our bedroom ceiling fell in. We filed a claim with Columbia Lloyds and learned about Actual vs Replacement Value. Wish I knew then what I know now in that alone. We understand that due to our ignorance (whether we believe our agent should have explained it or not) we will have to accept ACV; however, I have run into a couple of other questions that I cannot get answered from my insurance company.
    First of all, we had some slight damage on the left side of the roof in 2011 (it was leaking inside) and filed a claim. We received $2500 for what we assumed was for roof repairs (the paperwork doesn’t say partial or total), however, according to the insurance company they paid for a new roof and the paperwork shows that by saying that they gave us money for 20 squares (whatever that means). That being said, we did the repairs on the roof but did not do a whole new roof. Then we, recently, had this huge hailstorm and are being told that they will not cover the roof or any of the cost of damages that are due to the roof which consists of quite a bit. We have been paying for the insurance for the 3 yrs since that time with no knowledge that we weren’t even covered.
    We also had several items outside of the home that were damaged that we did receive a check for, minus depreciation. I understand that, but, they never asked when we purchased these items in order to know how many years to depreciate. Is that normal?
    I have tried to get answers from Columbia Lloyds but the only response that I have received is that they can’t and don’t have time to explain it to me and they hung up on me.
    So, first question… Is there any way that we can get the roof covered or at least the items, walls, and floors inside that were damaged? The entire neighborhood was damaged so whether it’s the repairs that we made or a new roof, as they now tell us it should have been, it would have happened anyway.
    Also, what are our options on the items that the adjuster (who by the way was a 3rd party adjuster hired by the insurance) didn’t get the information on in order to depreciate properly.
    Any help you can offer if greatly appreciated!
    Marian 🙂

  1809. July 11th, 2014 at 1:56 am #Jason

    Marian,
    I cannot conceivably imagine hail so large that it would cause damage to interior items, walls, and floors. I believe there is more involved with your claim than you have posted and I can’t answer that question. You were already paid for 2000 s.f. of roofing that you apparently didn’t have replaced. If hail damages something of which you have already been paid, you won’t be paid for the same item again.

    An independent third party doesn’t need to know the age or date of purchase to appropriately apply depreciation. Items wear out over time and through experience, these people can fairly apply depreciation based on their visual observation on the items.

  1810. July 11th, 2014 at 12:27 pm #Marian

    Hello Jason,

    We had hail the size of softballs – literally – look it up – Abilene, Texas… it was crazy!! They put holes in the roof so large that it caused the ceiling to fall which caused insulation and water damage to the room and the items inside. The hole is the size of a king-size bed – I know because it covered our entire bed.

    We had the roof repaired which is what we thought was required. We, just yesterday, had a “new roof” put on and it cost 4600 to just repair the holes and put on new shingles. Since the area where the ceiling fell in was on the side of the house that didn’t have any previous damage, I have a hard time believing that the shingles would have stopped the hail from coming through and the total allotted (before depreciation and deductible) in 2011 was approx. $4200, I don’t know how we could have put on an entirely new roof with that amount.

    On the depreciation amount, I guess I am very confused. I thought that items were depreciated by a % per year. If they didn’t know how long we had the items, how could they know how much to depreciate? If I am wrong, how do they go about figuring the depreciation.

    I apologize if I sound argumentative, that is not my intent. I am just trying to fully understand in order to make an informed decision on what our next step is. Thank you very much for your time.

    Marian

  1811. July 11th, 2014 at 1:28 pm #Jason

    Marian,
    You need to know your policy before you can understand it. Look at any page of your policy. You are looking for the form number and it will be something like HO 03 12 91. The important part are the 2 numbers after the HO. An 03 policy is a replacement policy – for the most part. What happens is when a claim is paid, the ACV is paid initially. When the repairs are made, then the rest is paid for the full replacement, less your deductible. The most common homeowner policy is a HO 03 policy. The numbers after the 03 in the example I’m using refers to the edition date of the policy, and in the example I use it would be December 1991.

    To know if you have replacement coverage in the policy, that can be found under the policy heading of Loss Settlement, or similar wording. Certain companies use their own policies but I would say the majority of policies are drafted by a third party insurance services company. Most policies cover almost all the exact same things whether written by the insurance company (like State Farm) or by the third party insurance services company.

    I don’t know the size of your entire roof but 20 squares is 2000 square feet. 1 square equals 100 s.f. On June 12, 2014, there was hail up to the size of 4.5 inches in Abilene. That’s big hail. The thing about a roof is that it not only consists of shingles, but it also has a roof deck called sheathing consisting of a wood based material that is between 1/2 to 3/4 inch thick. There is no way 4.5 hail should penetrate both the shingle layer and the roof sheathing (unless the roof is rotted, previously water damaged, or otherwise weakened).

    If you received $2500 for 20 squares, that seems to be the ACV for your damaged roof and based upon about 50% depreciation. The total cost of replacing your roof of 2000 square feet would be around $5000 (approx.) If you have a replacement policy and didn’t make a claim for replacement after the repair or replacement, then that additional money goes unused. You generally have 1 year to make a claim for the depreciation they applied to your claim. If more than a year passes, then no further payments will be made.

    If you want to send me a copy of the prior estimate so I can view it, you can attach a copy to an e-mail that you send to the e-mail address in orange lettering at the top of this page. If you send an e-mail, please also include the form number of your policy.

    Depreciation can be applied a number of ways and each insurance company does it differently. It can be a percentage, based on age/use, or a specific amount. The amount an independent claim adjuster applies as depreciation is generally accepted because their application of depreciation should be fairly accurate based on the item being depreciated.

    If a new roof was allowed for your prior claim, the roof was already paid for and won’t be paid again. The only exception to that is if the allowance for a new roof was paid and a new roof was applied to your home. If a new roof was paid for in 2011, then the insurance company may owe for the damaged roof sheathing damaged in this recent storm.

    A very recent trend in the wind/hail loss area of insurance is that many insurance companies are modifying deductible amounts to apply a percentage deductible (for example 1% of Coverage A limits) or a significantly higher wind/hail deductible compared to a lower deductible for other causes of loss, like water damage, covered by your policy.

  1812. July 21st, 2014 at 3:37 pm #Sharon

    Help.!!
    I have been given the run around and double talk over a very simple
    question, which is: When was HO-208, a sump pump failure loss first introduced as an endorsement offered by Hartford homeowners insurance???
    I do not recall ever having been offered such an endorsement over the many years I have held a Homeowners policy with Hartford. I have been a policyholder since 1986. They insist sump pump failure loss has “”always been offered” even before we were policy holders.
    Obviously, my policy, not owning such an endorsement, will not cover damage to contents due to sump pump failure during a recent flood and rain storm in Chicago.
    Help….I am absolutely worn out with all this double talk, evasive speech that poses as an explanation.
    Thanks, Sharon

  1813. July 21st, 2014 at 4:02 pm #Jason

    Sharon,
    That’s an irrelevant question. Who cares when it was first available in the market for Hartford or any insurance company?

    You don’t need to be offered anything. If you want insurance coverage for sump pump and water overflow, you need to add it to your policy.

    If you have a sump pump water loss without that endorsement then there is no coverage. Don’t focus on the questions and answers. Just focus on getting that endorsement attached to your policy if you want future coverage for a sump pump water loss.

  1814. July 30th, 2014 at 3:31 pm #Erica

    I pulled over into an apartment complex to use my phone. After finished, I put car in reverse and backed up, without seeing tree stump, I hit it. Damage to my bumper and self esteem. Am I responsible for damage or could property owners be responsible? They people that love there said they had just recently cut down trees and left a big wide tree stump, low enough that wasn’t visible in rear view or side mirrors. They also claimed, I was not the first vehicle to hit stump. So basically I am asking who is responsible for damage? Me or property owners?

  1815. July 30th, 2014 at 3:36 pm #Jason

    Erica,
    The person who backed into the tree is 100% responsible for the damage to the car.

    The is no possible way a property owner can be responsible for damage other people do to their cars.

  1816. July 30th, 2014 at 3:44 pm #Erica

    Well either way, the stump is literally on corner of property and just sitting there without any kind of flag or something to let you know it is there. My opinion, should be removed entirely and/or atleast be advertised it’s there. Was hoping it would be on them. Guess that’s what I get for stopping to use phone, should’ve just kept driving and used it. What I get for obeying the law

  1817. July 30th, 2014 at 3:49 pm #Jason

    Erica,
    With the permission of the property owner, you could put a flag on the stump. Or you could pay to have the stump removed. With your thinking, it seems you want everything that might not be seen, and possibly struck, decorated with a flag.

  1818. July 30th, 2014 at 5:08 pm #Erica

    Well I appreciate your sarcasm, but when there is a stump 2ft from parking space, cut low enough it’s out of sight then yes it needs flagged!

  1819. July 31st, 2014 at 9:49 pm #Matt

    Please help me.
    I have had two previous insurance claims due to storm damage to my home in the last 2-years and now have another claim due to hail damage to my roof. I had a contractor tell me that the damage is enough to get my roof replaced and now have put in the claim and sure enough the adjuster came back and will pay for it. What I am concerned about is, will my insurance company cancel me because I am now putting a 3rd claim in within 2-years? And will they raise my premiums because of it?
    Thanks, Matt

  1820. August 1st, 2014 at 2:16 pm #Jason

    Matt,
    Those questions can best be answered by your agent.

  1821. August 7th, 2014 at 7:09 am #alice

    We had our roof repaired, but the company hasn’t called or come by to get their payment. How long, legally, do they have to get paid? We live in Texas. I’m thinking if they dont come or call in a month I can keep the money and not pay. Am I correct?

    Thanks.

  1822. August 7th, 2014 at 9:43 pm #Jason

    Alice,
    Your question has nothing to do with insurance. But since your question is so off-the-wall, I will provide a response.

    In TX, like many states in this country, there is likely a 5-7 year period for a debt to be collected. A debt does not go away after 30 days. Since you owe this contractor money, why don’t you take the initiative to send the payment to them? The roofer did the repairs – why don’t you make a little bit of an effort and put their check in an envelope and send it to them?

  1823. August 12th, 2014 at 6:31 pm #Sean

    Hi,

    A car hit our house and caused major damage. When we received the first estimate from our insurance adjuster, I was upset there was no mention of floors sagging upstairs, or a beam in the basement that started to twist from the house moving a few inches. (the car hit the northeast corner and shifted the front of the house and punched out blocks on the northwest side, sending cracks in the basement blocks 3/4 of the way along that wall to the SE corner…the beam in question is 1/2 along that wall, and the floors on the 2nd floor room directly above are sagging)

    This was brought to the attention of the adjuster who advised that we would take care of what was major now, and wait until the house was moved, and then deal with supplemental. (I have emails)

    We ended up needing to get a new contractor as the 1st did nothing for 3 months. When we met the new one, he said he had never seen such a bad report from a structural engineer. Almost like he had no clue how to do his job. Once I heard that, my ears perked as the 1st contractor was mentioned by our adjuster as one they work with, and why these obvious issues (to me) that we brought up that werent mentioned in the report seemed strange.

    At one point the new contractor called the adjuster to mention the floors on the 1st floor sagging, and that we wanted our insurance to cover the cost of jacking up the floors to level them as the middle of the house was going down slightly. The adjuster denied this claim, and the structural engineer immediately said “pre existing” without even taking a pause during my contractors call to even pretend to look at any files after 7 months since he’d been there. Our contractor let me know that and I immediately sent him our home inspection from the year before, which had no mention of any floor issues. He called the adjuster back, and wouldn’t you know it, he added an extra couple thousand for it and some beams were installed below the impact and the floors lifted at the center of the house.

    It’s now been a year since the car hit the house, and we’ve been back in the house for 5 months. Slowly, the house is settling, and doors are not able to be closed easily like they were when we moved back in. The floor upstairs is sagging, and the beam on the opposite side of the basement is still twisted, and doing it more so…which directly effects the floor on the 2nd floor, but apparently not!

    The wall on the first floor above that beam had several cracks from the accident and had to be redrywalled, which shows me there was significant stress from impact, which should show the twisted beam below would be an obvious connection.

    I emailed the adjuster letting him know of the issues that remained, and the ones popping up after moving the house and lifting the floors. He emailed a 3rd party, I mean THE SAME ENGINEER to come out and reinspect the house. Oddly enough, it’s all preexisting and they feel no more money is due.

    Now, my wife and I were totally ignorant to the entire process and look back and shake our heads, but the one thing we knew to do was save everything. I looked at the first report, and there is zero mention of anything to do with floors, or this beam…and this report is a joke. About 20 low grade photos and a couple bullet points. Some of the photos are even of the wall above the beam and cider blocks below the beam. The 2nd report has no pictures and a couple paragraphs stating “preexisting” or “due to fixes” made during the contractors repairs.

    What advice or steps should I take as the adjuster ok’d the work, the insurance is supposed to return the house to “as it was or better” status, and the engineer they brought in seems to either not know his job, or is in cahoots with the adjuster?

    Thanks for your time!

  1824. August 14th, 2014 at 6:09 am #Danielle

    I let a couple with 2 small children stay in my home for a year. They were going through some hard times and I had a small condo I could stay in. Problem was they let their kids run wild!! Ruined all the bedroom rugs, damaged all the furniture and colored on all the walls. My homeowners is through peerless. Do you think I can make a claim?

  1825. August 14th, 2014 at 8:03 am #Jason

    Danielle,
    You can make a claim for anything you want. With your situation, the couple and the kids were your tenants without paying rent. The activities of the couple and the kids amount to wear and tear and may seem like excessive wear and tear but wear and tear can range from mild to extreme. I don’t see coverage for your home condition due to this family living there.

  1826. September 8th, 2014 at 4:20 pm #Elizabeth

    I am appealing my home owners insurance. An icemaker with a pin hole leak sprayed onto the underside of the floor under the crawlspace. The damage is approx. 20 ft in diameter, damaging four rooms. There is no rot, although the water damage report (insurance recommended company) claimed there is. The adjuster never went under the house. He looked at pictures from the water damage company and read the report which has incorrect information in it. There was no evidence of the water leak. It was found by the need to install a propane line under the home. I called the local insurance manager first and tried to explain my case. He too said the pictures showed dark wood, mold and mildew. I had another company not affiliated with the insurance come out and verify no rot. He took pictures and offered them to me for insurance purposes. What should I focus on the most in my letter? I was denied due to leakage over a period of time and wear and tear (ice maker line). The icemaker line was installed with brand new frig in 2012 and was leak tested. Thank you for any advise!

  1827. September 8th, 2014 at 4:35 pm #Jason

    Elizabeth,
    There is no appeal for denied insurance claims. Your policy covers sudden and accidental damage. The leak that you had was not sudden.

    Focus on not wasting your time by sending a letter. If you believe your claim is a covered loss, go straight to court (with an attorney) . If you don’t believe your claim is covered, based on the circumstances, move on with life.

  1828. September 8th, 2014 at 5:18 pm #Tammy H.

    I know it is typical for houses to “settle” over the years. Just in the last few months I am seeing drastic issues. Basement wall is beginning to “shift” at one side of house. Just in the past month I had a section of roofing shingles come loose and fall off. Roofer came out and re-set in place. He advised that about 1/2 of the front portion of my roof all the shingles seem to be “shiftiing”. In the past week I am experience more than average creaks and cracking noises and seeing several “scary” cracks appearing in the ceiling in a room in the same section of the house. I had a guy come out and look at it and he said it is basically from ground shifting/eroding and causing strain to that wall/corner of the house. He said could cost $10K++. I am on Social Security Disability and barely am able to keep up with mrtg. & utuilities 🙁 Is it at all possible that my Allstate Homeowner’s Policy would cover??

  1829. September 8th, 2014 at 5:41 pm #Jason

    Tammy,
    Shifting, settling, and cracking are specifically named conditions that are excluded in most policies, so no, it would not be covered.

    Your current insurer is rated as one of the worst insurance companies for claim satisfaction. You may want to do yourself a favor and switch to a company that is rated better. At the top of this site is a link called Best and Worst Rated Insurance Companies.

  1830. September 10th, 2014 at 11:20 am #Coleen

    My dogs died while I was on vacation from heat stroke because the thermometer on the air condition broke. Can I claim this accident on home owners insurance. We are heart broken, we had two English Bull Dogs.

  1831. September 10th, 2014 at 12:05 pm #Jason

    Coleen,
    The thermometer likely would not be covered if it broke on it’s own. If there was a covered cause of loss that caused it to break, it’s likely a lot less than your deductible.

    If you are asking if you can claim your dogs – no, because homeowner insurance is not a life insurance policy for humans or animals.

  1832. September 15th, 2014 at 1:32 pm #Mary Ann

    I submitted an insurance claim for water damage caused due to ice damming in February. It was State Farm, who sent out their adjuster. Long story short, I wished I had found this site MUCH earlier. I have had 2 instances of ice damming but on different sections of the house. In both cases, State Farm treated it identical and mailed me a minimal check — less the $1,000 deductible, of course. In good conscience I returned their check each time with a letter stating that I couldn’t take care of the damage caused with such a small amount, I was returning it. My agent said there was no problem. Right! Just before Labor Day I received a cancellation notice in the mail stating that since I have not taken care of my home they couldn’t continue the risk of coverage. Am I naive to think I can go back as ask for those checks that were sent? Probably. I ended paying an exorbitant amount for my new coverage and that even included upping my deductible to $5K!!! I have been totally burned and just hope Mother Nature is good to me for a really long time! Any advise??

  1833. September 15th, 2014 at 7:20 pm #Jason

    Mary,
    Yes, you are naive to think you can ask for those checks back – but do it anyway. They are legitimate claims and because you sent the checks back and now you want them, the claims are not settled. Just call and have them reissue the checks.

    Don’t rely on mother nature when you have ice dams. You have to correct the underlying problem and that is a lack of insulation in your attic. When heat escapes from your roof to quickly, it melts the ice and snow on your roof, when the moisture gets to the lower point of your roof where there is no more heat, it freezes and causes a dam where the water that is melting above it gets caught up. This water has no place to go with this dam there except through your roof and into your home.

    As for an insurance company – keep looking. Look for a mutual insurance company sold by an independent insurance agent who sells insurance for multiple companies instead of just one like allstate, farmers, state farm, etc. If you moved from state farm to farmers or allstate, you just made a move from bad to worse.

  1834. September 18th, 2014 at 1:57 pm #Brendan

    Both parents are deceased. The Mortgage and homeowners insurance policy is in my parent’s names and we have not probabted the will yet. There is water damage due to rains to the existing roof and there is also water damage in the basement and mold growth. I am living in the house and currently making the mortgage payments on the house, even though the mortgage and the homeowners policy is not in my name can I use the existing homeownerws coverage to cover the cost of the reapirs to the roof and basement. Or would I have to have to become the executior of my parents estate to have the cost covered. Any help would be much appreaciated.

  1835. September 18th, 2014 at 3:09 pm #Jason

    Brendan,
    You might want to get the rain water to stop entering the house because rainwater should not be gettting in. Based on how you indicate what’s going on, I don’t even know if there would be coverage for what’s happening.

    You can make a claim but I don’t know how the insurance company will address the entire situation. Why don’t you get the ownership of the house figured out so you don’t have to be in limbo because that’s where you’re at right now.

  1836. September 23rd, 2014 at 5:26 am #Kris

    My son struck another students car with his lunch bag causing a dent in the hood. The other student was pulling out of a parking spot as my son was walking in front of the car to get to his truck. The owners want us to pay for the dent. I was told I can turn this in to my homeowners insurance. Is this correct?

  1837. September 23rd, 2014 at 7:03 am #Jason

    Kris,
    It does sound like something a homeowner policy would look at to see if they owe liability to the car owner but it appears like it would be denied because they don’t cover intentional acts of damage.

    If your son wants to cause property damage, he should take responsibility for his actions and pay for the damage he caused.

  1838. October 3rd, 2014 at 10:55 am #Michael

    5-6 years ago, I had a roof leak. I fixed it immediately. The damage was pretty extensive. Ceilings, floors, fixtures damages etc. It is a warehouse. I never thought to file a claim. Am I too late? Thank you…

  1839. October 3rd, 2014 at 4:48 pm #Jason

    Michael,
    Generally, the time frame to file a claim is prior to 1 (or even up to 2) years. If the claim is 5-6 years ago, your damage would very likely be too long ago to successfully file a claim.

  1840. October 5th, 2014 at 7:35 am #karen

    hi – my 91 year old dad left the faucet running in his bathroom in the middle of the night – by the time i got up in the am – the water had gone through the floor – into the kitchen ceiling – 3-4 inches on the kitchen floor and down to the cellar. also destroyed my downstairs bathroom ceiling and made “bubbles” in the pain on the walls that we had to puncture to let the water out. we called the insurance company (baystate/andover) they said they would have someone call right away. did not happen. some of the ceiling tiles in the kitchen have fallen now – and i see what looks like mold starting to grow – our house is kept VERY warm because of my dad. we will call again today – but adjusters will not be able to come out until tomorrow – as we will not be home. is this something that they will cover? and – how do i determine if my policy covers mold?

  1841. October 5th, 2014 at 9:50 am #Jason

    karen,
    From the information you posted, it appears the loss will be covered. I fail to see why there would be mold developing after just a day or two from a water loss. Mold generally is covered, with a monetary limitation, after a covered cause of loss so it should be covered. If you want to check, review your policy for mold coverage/limitation information.

  1842. October 11th, 2014 at 8:55 am #Amy

    Hello, My husband’s house flooded. We were using the basement for storage as we were combining our two homes into one as we are recently married, and we were preparing to put that house up for sale. We do not reside in the house.

    The insurance company suggested a water mitigation company they work with. We agreed. The company wanted permission to throw away anything that was destroyed by the water. My husband asked how it would be documented. They responded that they take pictures of everything.

    The water mitigation company took pictures of 157 large black bags. NOT the contents.

    it’s been 6 months, we haven’t been able to resolve this with our insurance company. We aren’t sure exactly what all we had in the basement. Combining two houses into one, we were storing a houseful of items until we decided what we wanted to do. We had sold or given away most of the excess furniture we had. It was household items.

  1843. October 12th, 2014 at 3:59 pm #Suzanne Porter

    I have State Farm Insurance. The contractor is finally getting a chance to do the repairs on my mobile home from Hurricane Sandy. The roof had to totally be replaced and they also agreed to pay to replace two thirds of the skirting. On Friday when they removed the skirting we found that the home has tilted and in some areas it is off its supports, Some of the supports are now buried in 3-4 inches of mud and a few are cracked. I was informed that the whole home has to be re-leveled. Because it is un-level some of my windows won’t open and one has broken. When the insurance claim agent did his estimate and appraisal I was not aware of these problems. What can I do about getting these covered? The claims adjuster I was assigned is not very helpful.

  1844. October 12th, 2014 at 6:10 pm #Jason

    Suzanne,
    Contact the claim adjuster’s manager and express your concerns to him/her about your claim and request prompt action.

  1845. October 21st, 2014 at 11:30 am #Jody

    I had a claim with American National for a rental property of mine that had the copper stolen from our 4 air conditioners from the condensers to the house. We filed the appropriate claim, received estimates and the adjuster gave us his estimate which came in around $2,500. However, they told us that they would apply depreciation to the replacement of the copper of 65%. (It is a cash value policy, not replacement value.) After the depreciation and our deductible, none of the claim will be covered. Is it correct for them to take depreciation of the copper? I was shocked by this, as if you needed to replace an air conditiioning unit, you would reuse the copper that was there, not replace with new. My agent also doesn’t agree with their assessment and is following up with them but has not gotten very far. I appreciate your insight.

  1846. October 21st, 2014 at 7:40 pm #Jason

    Jody,
    Depreciation is appropriately applied to any claim, even one that is a replacement policy. Depreciation has to be applied to your claim so it is known what to pay based on your ACV policy.

    I don’t know the age of your condenser lines was but, my initial perception is that using 65% deprecation may be a bit high.

    I reviewed the depreciation guidelines for copper lines in a popular estimating software program and 2% depreciation per year is a recommended guideline.

  1847. October 30th, 2014 at 10:21 am #susan

    My sister had a roof put on her house 4 years ago to replace recalled corning shingles. She chose a 30 yr shingle and payed out of pocket for the new roof. Now her roof is leaking and the damage to her house is tremendous. The insurance company is refusing to pay because the roofer put the new shingles over old and he is no where to be found. She also had bought a furnace from Lennox that has been leaking condensation into her basement causing mold to grow there. Lennox will not honor their warranty. She now has mold in her basement and attic. She has been dealing with leaking Pella windows and lack of insulation in this house since she bought it. The house passed inspection when she bought it. Now she has 20-30 thousand dollars worth of damage to fix. What can she do? She has talked to a lawyer and he says she has no options. HELP!

  1848. October 30th, 2014 at 4:34 pm #Larry

    I recently had a sudden pipe leak in the wall between the dining room and kitchen. the water flowed to the family room and destroyed the wood floors. The living room has matching floors. The dining room is a 6 inch raised tiled room. On opposite sides of room there are no walls, open view back and forth from family room to living room. I am asking for the floors to be replaced in both rooms since the type wood flooring we have is no longer manufactured. The adjuster is telling me that the dining room acts as a natural break and will not be replaced. Our concern is that we will not have matching floors in rooms that are clearly in the line of site of one another both from the dining room, living room, family room and part of the kitchen. Would the living room, which did not have water damage, be covered in California as well? curious on your take before I go up the chain of command at State Farm.

  1849. October 30th, 2014 at 6:58 pm #Jason

    Larry,
    Your policy covers direct physical damage. If the flooring is not damaged, why should it be replaced?

    Let me put this another way – would you had to pay for replacing undamaged flooring in your living room if it was out of your pocket? If you would not replace it if you had to pay for it, why should you insist it be replaced due to payment made by someone other than you?

    Matching is not a covered cause of loss in a homeowner’s policy.

  1850. October 30th, 2014 at 7:06 pm #Jason

    susan,
    Your sister can remedy the problems with her home and repair the damage. There are responsibilities that come with home ownership and maintenance and upkeep are expenses that a homeowner has to endure.

  1851. November 4th, 2014 at 12:48 am #Todd

    Hi, great site. I have a quick question. I built a home in the mountains in Tennessee in an unincorporated area. Water is flowing in off the road and essentially washing the earth from my house to the point where my one wall is beginning to buckle a bit. I had the contractor put a lot of steel into the footers but am concerned that my renters may be at risk. Is this something my homeowners insurance would cover?

  1852. November 4th, 2014 at 4:16 am #Jason

    Todd,
    Generally water, at or below ground level, is an excluded cause of loss. That seems to be what is happening based on the information you provided.

  1853. November 5th, 2014 at 6:42 am #Georgia

    I live in Texas and we bought our house 4.5 years ago. I was painting our front entry and that is when I discovered our problem. The previous owners had replaced the roof not too long before they sold the house due to a hail storm.

    It turns out they waited a while and there is water damage. The dry wall is crumbling and super soft, all along the front door the wood is falling apart. My question is if we are able to file a claim and use our insurance to cover this as the repairs are going to be costly to cover the area that is damaged. Our home inspection company missed this and I am not sure how as it is pretty obvious to me now that I know about it and it was their job :(.

  1854. November 5th, 2014 at 5:21 pm #Jason

    Georgia,
    I don’t get it. You said the water damage is due to the previous owners actions from 4.5 years ago. That doesn’t really explain why the drywall is soft and brittle right now. If damage happened over 4 years ago, there likely is no coverage.

    Unknown to you, the damage may not be related to the prior owner at all and may be a recent incident. You won’t know if coverage applies unless, and until, you make a claim.

  1855. November 8th, 2014 at 8:35 am #Kathy

    Hi. My Dad had a fire in his “shop”. A separate garage where he worked on cars etc. the insurance company is denying it & most of the tools as “business”. However, the thing is, my Dad is 80! He’s not running a business & has only been working on cars for friends/church/etc since my mom passed away two years ago. The insurance company keeps asking for tax returns & bank statements, which he has provided. However, the bank would only go back two years for statements & the insurance co wants FIVE years! Is my Dad obligated to provide this? Does it even matter if he had a business (he didn’t) five years ago? Isn’t the policy period just for the current year, whenever he renewed it?
    Thanks

  1856. November 8th, 2014 at 12:24 pm #Jason

    Kathy,
    If the insurance company is requesting information, your dad is required to provide it. I don’t know what kind of policy or coverage your dad has so I can’t answer about the issue of business or not.

    Yes, the policy period is defined and is generally 1 year in duration but the policy period is for the time of coverage – the concern seems to be if the property is business property or personal property.

  1857. November 9th, 2014 at 2:28 am #Kathy

    Hi again. The concern is regarding whether or not he is running a business as this is a homeowners policy.
    My Dad already told them that he used to but he hasn’t the last couple years.
    The insurance company first denied almost everything as business. Then my father called the adjuster again saying it wasn’t a business. The adjuster asked for his last tax return, which Dad provided. Then after another 2 weeks, the adjuster wanted his bank statements. Why is he required to provide information 4 years prior to the effective date (saying the effective date is the renewal date) of the insurance? Why is this relevant? So your telling me the insurance co can keep stalling & asking for other information? It’d already been a couple months. Dad told the adjuster he didn’t get the previous 3 years (2010-2012) because the bank said he’d have to pay $200 for this. So he received oct 2012-oct 2014.
    My Dad has never denied that he used to get paid for some of his work at home (although, it’s never been his only work, he’s worked at a landscaping co for 40 yrs) so I don’t understand why they’d need more than 2 yrs in statements. I mean, how long does a business have to be out of business before the insurance company will consider him out of business??
    Also, they told my dad they found online that he has a business & 2 employees & made 76,000. First of all, he’s never made that much money. My Dad knows nothing about the internet so I had him ask the adjuster for a copy. It was quite fishy because it’s from manta.com and, if you’re familiar, anyone can put their business or someone else’s business on there. I looked at the Indiana Secretary of State website (because the person who entered my dad’s info said it was incorporated in 2007) & none of my father’s info is listed. I’m sure the adjuster put that on manta. There’s a note on their, showing it was third party it says “our records indicate this business was incorporated in 2009. Current estimates show a revenue of 76,000 & 2 employees. All lies. This seems unethical to me. And why would my father, at age 75, incorporate a business?
    How long can the insurance drag things out?
    Thanks
    Kathy

  1858. November 9th, 2014 at 7:07 am #Jason

    Kathy,
    The intent and purpose of a homeowner policy is to protect the home, personal property, and the family occupants from claims of negligence. The intent and purpose of a howeowner policy is to not provide coverage for business property. Business property is best protected under a business policy.

    For example, a common homeowner policy has the following limitation concerning business property: $2500 on property, on the “residence premises,” used at any time or in any manner for any “business” purpose.

    The same policy, but updated about 10 years later uses the following language: $2,500 on property, on the “residence premises”, used primarily for “business” purposes.

    Business is defined in the above example policies by the following: “Business” includes trade, profession or occupation.

    The first business limitation above makes it clear that the business property is business property if EVER used in that manner. The second business limitation seems to remove the time element of when it was used last.

    I don’t think the insurance company is dragging this out. I think they provided limited coverage for some of the items and you don’t agree with that.

    If the adjuster asks for 5 years of records, I don’t care if it costs $20, $200, or $2000 to get. If those records are not provided, there is a cooperation clause of the policy and if your father doesn’t provide the requested information, he is not cooperating.

    I can assure you – the adjuster did not put anything on manta as you suggest he/she did. I don’t know why people incorporate a business. If you want to know why your father incorporated his business, you shouldn’t ask me – ask him. Age has nothing to do with incorporation status. Corporate information is public so the information could have come from the Department of Revenue for your father’s business – but I don’t know.

  1859. November 9th, 2014 at 4:46 pm #Kathy

    Hi again. Clearly I’m not saying things correctly, I guess. My father did not incorporate his business. Ever. My point was just that it seemed odd that whomever put that on manta said it was incorporated 5 years ago. I don’t know if you noticed I said I checked with the Secretary of State website & nothing is listed for him as far as an incorporated business. The manta thing that seemed odd is that it pulled up several other people in our area that all said the same annual revenue of 76,000. Manta said any third party can enter info. Also, I didn’t understand why the adjuster would provide as “proof” a website that anyone can put anything on instead of a legit statement from a government source.
    That’s what seemed strange, as well. Why not check with the dept of revenue?
    So, pretty much, he has no chance of recouping for his loss, it seems? He’s never had any employees and really just did some work on the weekends at home. He never realized he needed a different policy, he told his agent what he used the building for & he said the agent said it’s really just a “hobby shop”. It just seems unfortunate when he tried to do the right thing.

  1860. November 9th, 2014 at 5:12 pm #Jason

    Kathy,
    Incorporation is not a requirement to have business personal property. Simply doing business activity with the property is enough. Don’t get hung up on corporate or non-corporate status. Individuals can be fully involved in business activities – regardless of their age.

    If you are talking about recouping for the business personal property, he was probably paid the policy limit for that property. He doesn’t need to realize he needs a different policy in order for that need to be real.

    Anybody can rationalize anything anyway they want. If the agent thought it was a hobby shop when it was a business shop, then the agent’s perceptions were off the mark.

  1861. November 10th, 2014 at 7:15 am #F MICHAEL cONTE

    JASON, I HAVE BEEN FOLLOWING YOUR BLOG FOR YEARS NOW. I MUST SAY YOUR ANSWERS ARE ALWAYS ON POINT AND , I LEARN FROM EVERY SCENARIO THROWN AT YOU.
    I HAVE BEEN DOING THIS FOR A FEW YEARS SO I AM NOT EASILY IMPRESED.

    THE VALUE THAT YOUR CONTRIBUTORS GET FROM YOUR ANSWERS ARE PRICELESS, I SOMETIMES WONDER HOW YOU HAVE THE PATIENCE.

    THANK YOU FOR THE ALWAYS GOOD INFORMATION.

    FM CONTE
    INSURANCE BROKER NY NY.

  1862. November 10th, 2014 at 5:15 pm #Jason

    FM Conte,
    I appreciate your feedback. To set the record straight, this is not my site. This site is the brain-child of a former (maybe part-time) public adjuster on the west coast. At least that is my understanding.

    My love and interest of the insurance industry is huge. I’ve experienced a lot and have been on both sides of the isle with the insurance company and as the customer (insured). Because of that, I know the insurance company has the benefit and upperhand when it comes to claims. I want to level the playing field as much as I can.

    When I know fairness can’t be reached, I say it like it is. For example, I can’t express how meaningless it is for an insured to contact their state department of insurance and hope for a positive resolution. The DOI is in business only to make sure the insurance industry continues to survive in the state. It has little or no concern about individual insureds.

    I’ve seen your responses too and they are accurate and honest.

  1863. November 26th, 2014 at 8:27 am #Irina Cruceanu

    My next door neighbor ( I live in a condo) had his sprinklers froze and blown out due to cold weather and not keeping warm inside and consequently the water infiltrated through the wail and floor into my condo. I tried to file claim with his insurance agent and they deny it.
    saying he did nothing wrong, the sprinklers just malfunctioned.
    I do not have my own insurance.
    Am I completely on my own?

  1864. November 26th, 2014 at 8:37 am #Irina Cruceanu

    Hi,
    My neighbor next door had his sprinklers in his condo frozen and they broke loose releasing a lot of water, so because we share a wall the water came into my condo through the floor. I do have proof that water came from him, and the sprinkler froze because he did not keep his temperature warm enough inside the condo.
    Is he liable for my damages?. He did file claim with his insurance but his agent denies my claim , I do not have insurance of my owne

  1865. November 26th, 2014 at 9:26 am #f m conte

    First i would ask if you have a managing agent that will share the repair report this will indicate what occured, second i would ask if you have a formal denial from an insurance carrier or just your neighbor or his agent advising of no coverage.
    if it is the later either report the claim directly to the carrier if you know who it is or report via certified mail to the agent, this will force him to report the cliam to the insurer. failure to provide proper heat would be considered negligence and this should be your allegation unless precipitated by euiptment failure. I would only accept a formal written denial. I would also suggest getting condo insurance.

  1866. November 26th, 2014 at 12:35 pm #Irina Cruceanu

    I did get insurance. thanks for the advice. I said to the agent that failure to provide enough heat is negligence but he keep saying that heat was on.
    I just got a verbal denial and the agent does not answer his phone anymore.
    I will send a letter asking for claim as you said because he does not answer the phone anymore.
    I do have some evidence, pictures that I took while workers worked in the neighbor’s condo with the sprinkler that blow out really close to the common wall, and also the thermostat being taped with a note saying “do not touch this” proof that the temperature was set too low so now he did not want anybody to change it. But what can I do if they do not cooperate? Do I have to sue?

  1867. November 26th, 2014 at 9:01 pm #Jason

    Irina,
    Proving negligence is difficult. Do not touch this is not proof of anything. Perhaps the battery in the thermostat died and was not sending a heat signal to the furnace. Perhaps a relay went out in the furnace and had nothing to do with the set temperature. Maybe the sprinkler did malfuntion regardless of the temperature in the unit. Also, what is too low of a temperature? There are so many things you would have to prove or dis-prove in court that you would certainly need a lawyer. My observation is you likely would not prevail and you would have to pay for the court costs and your attorney fees. I would advise to take that money, make your condo repairs, and don’t rely on other people’s insurance to protect your property.

  1868. December 2nd, 2014 at 9:42 am #Leonie

    After Katrina we received money for repairs and did what we could with the money. We should have received replacement value but of course everything was depreciated. We could not afford, with the money they gave us to replace the wood floors, so we did not recover the recoverable depreciation. Now, 10 years later we had a leak and the wood floors are buckling. They are saying that since we did not provide the receipts for the repair 10 years ago, they do not have to pay out. Is this correct? There isn’t a statute of limitations on claims, since that was 10 years ago. There was no way we could replace with the money they gave us then. If we replaced the floors now is there anyway to recover the recoverable depreciation from then or to take off the amount that we received then from the cost now?

  1869. December 2nd, 2014 at 6:01 pm #Jason

    Leonie,
    To your first question, yes that is correct. There is no statute of limitations concerning claims like your suggested.

    No, there is nothing you can do relating to your prior or your current claim. The one from 10 years ago is long settled and the hardwood floor for this current claim is being denied.

  1870. January 9th, 2015 at 11:57 am #Tracy

    My son died at his friends parents house. They were disposing a few old fireworks by cutting the wrappers and pouring the content into a solo cup. Then, they set the cup outside in the rain. When they cut into one and poured the content into the cup, it exploded by means of a flash explosion from the static in the air (no flame involved). My son was holding the cup. He died. His friends parents were out of town when that happened. The friend’s parents homeowners insurance company called and offered me half the “Liability” policy on the basis they feel my son was half the blame. Any advice?

  1871. January 9th, 2015 at 12:05 pm #Jason

    Tracy,
    No, that is something you need to discuss with an attorney. Your topic is liability/negligence, not insurance.

  1872. January 10th, 2015 at 8:13 am #Home Insurance Claim Blog | Insurance

    […] Home Insurance Claims Advice – FREE Q&A – Build … – Fast and FREE expert advice, help and answers to home insurance claims questions. NO LOGIN ! Maximize your claim LEGITIMATELY with CONFIDENCE!… […]

  1873. January 16th, 2015 at 8:57 am #Patricia

    I have statefarm as insurance in MN. I found out by the plumber that i had a leak inside the wall. By the time we saw it or was visible to the eye until it caused Water damage. Im taking care of it as soon as i seen. Im just wondering if my insurance will pay for the damages.. Im taking care of asap… I just dunno what to expect.. Made a claim an the adjuster is coming out. The leak is a start of a drainage pipe but hide in the wall… Ugh just wish i could found or seen it sooner.. The plumber said i wouldnt.. Im just dont know what to think.. I pray i get help..

  1874. January 16th, 2015 at 5:53 pm #Jason

    Patricia,
    With the information you provided, I am unable to determine if your water claim will be covered.

  1875. January 22nd, 2015 at 8:37 am #Chris

    Hi Jason!

    I love this board! I posted back in May, 2013 regarding a water heater leak I had in a condo I own that did about $7500 in damages to the condo below mine.

    I haven’t responded to any of the letters from their insurance agency / collection agency (Nationwide Insurance and NCS Collections).

    I just received another letter saying the collection agency is going to submit the claim to their legal department, blah blah blah.

    My question: Is there a statute of limitations of how long they have to file if they do try to sue me?

    FYI, my original post was May 11th, 2013 at 11:14 pm.

    Thanks again

  1876. January 22nd, 2015 at 6:06 pm #Jason

    Hi Chris,
    The statute of limitations for property damage is 3 years in the state of Nevada. They would have to file a summons and complaint before 3 years has elapsed from the date of the occurrence.

    I would be ignoring their letters too. I can’t even imagine them finding an attorney who would take any legal action since there is no negligence on your part.

  1877. January 24th, 2015 at 4:21 am #Jane

    we just purchase a home December 18th, we gave our landlord the month notice, we were going back and forth over the house, putting furniture in the garage, as we were having the floors done….
    whilst still going through the rooms upstairs there was not heat, so we had the guys who did the house come and fix….a couple of days later once the floor were done, I heard a bubbling sound from the same bedroom, when to the basement, flooded, the dining room walls damaged, the ceiling soaked….
    SEVPRO came out, the adjust came out, ask when did I purchase the home.
    Now I got a letter from the insurance stating that my policy will be canceled -due to NON DWELLING WITHIN 30 DAYS….
    according to the plumber, the previous guys did a b ad job, no air check on the heating…the pipes upstairs were BLEED?….
    I am at a loss

  1878. January 26th, 2015 at 4:14 pm #F Michael conte

    Jane,

    I am not sure as to what you are asking. Please present your questions and I will do my best to answer.

  1879. February 12th, 2015 at 3:35 pm #Kari

    This past summer we filed a claim for hail damage to our home and car port. Everything on the insurance side went fine, but the roofing team hired by our contractor was a joke. They left the peak to our A-frame home open over a weekend that had forecasted record rainfall. Our house was flooded. The roofers finished the roof, fixed the floors, paid for the chemdry folks to come immediately, and contracted a drywaller to replace the ceilings. The contractor stated that we should not inform our insurance company of the incident because it would mark the house with flood damage. Lately it has been noted by others we know that the contractor is a bit shady (I’m also still waiting on some small fixes from the flooding like toe kick in the kitchen). Did we do right by NOT letting the insurance know the house got flooded by these guys, or should we let them know about it?
    Thanks.

  1880. February 12th, 2015 at 4:55 pm #Chris

    Hey Jason,

    It’s Chris again. I’ve posted a couple times regarding a rental condo in Las Vegas. My hot water heater sprung a leak in May, 2013, which caused damage to the condo below mine. I didn’t have insurance on my unit (but do now of course).

    Nationwide insurance, the company representing the condo below mine, sent me letters telling me I was responsible for the damage to the condo below. The amount is $7500.

    Nationwide then contracted a collection agency Nationwide Commercial Services (NCS). I have not responded to any letters from either of them.

    Today, I received a letter from the Law Offices of Jay W. Smith, 6644 Valjean Ave , Suite 200, Van Nuys, CA 91406. I’ve done some searches online, and it seems they are part of NCS. NCS is in Suite 100, Jay W Smith is in Suite 200.

    The letter says:

    “Please be advised that this law firm has been retained by NCS to assist them in the collection of the above referenced matter. By the way of explanation, referring an assignment such as this to our firm is done only after traditional collection efforts have failed to bring results.

    Therefore, unless you take immediate steps to satisfy this obligation, we will advise our client to file suit through local counsel in the appropriate court of jurisdiction. We shall refrain from filing suit until approval is given in order to give you sufficient time to contact NCS at (818) 701-4400 to reach a mutually beneficial agreement.

    It is our sincere desire to avoid the time, expense and inconvenience to all parties brought about by a lawsuit. To that end, we are willing to consider all reasonable proposals. Furthermore, if you sincerely believe you are not liable, we welcome any explanation you may have. ”

    So, what do you think? Should I continue ignoring the letters? Any thoughts or advice are verrrrrry appreciated 🙂

    Thank you, Chris

  1881. February 12th, 2015 at 8:45 pm #Jason

    Kari,
    You can do anything you want as far as telling who ever you want about the failings of the roofing contractors. What is the big deal about your insurance company knowing your roofing contractor caused damage to your home?

    Just make sure the responsible company takes care of all the water damage.

    If a shady contactor tells you to do or not to do something, you need to realize they probably have something shady going on about the guidance they provided.

  1882. February 12th, 2015 at 8:55 pm #Jason

    Chris,
    Yes, please recognize how awkward the wording is in the letter to confuse you (and others) that their involvement is any different than the same collection agency (company). They have no approval to pursue legal action against you – based on their awkward wording. I would ignore them and any other collection attempts – – other than an actual summons and complaint.

    With a summons and complaint, you should be able to effieciently provide information to the court that you have absolutely no liablility to them and the suit should be dismissed. This shouldn’t be a concern unless they pursue this action. Their action would be based on an unactionable position which cannot be supported based on the facts.

    (None of the information in this post should be construed to be legal advice since I am not an attorney.)

  1883. February 19th, 2015 at 2:26 pm #Peter

    Hi, I recently had a water loss in my home. I got the estimate for the repairs minus the recoverable depreciation.
    The damage is so big and I was selling the house before that anyway, that the stress, time and effort to replace the damage, in addition to the time loss from selling it, the mortgage payments, utility bills, etc. is not worth it in my opinion.

    If I decide to level the house and sell the lot without the house, will I get the recoverable depreciation back? Can I fight the insurance on this if they don’t want to give it to me. It’s still a loss on my pocket, just one that I rather not go through by fixing it.

    I think that the loss is so big that it’s not worth it, especially considering that I have to disclose the mold, water damage, months of repairs, etc…. I can see how someone would not want to buy the house on that alone.

    What should I do?

  1884. February 19th, 2015 at 7:36 pm #Jason

    Peter,
    Nope, you won’t collect the recoverable depreciation. You can fight the insurance company all you want – no matter what you do, if you don’t repair, you will never collect the recoverable depreciation.

    Either fix the home to collect the full cost of the repairs or simply take the ACV settlement and end it there.

  1885. February 24th, 2015 at 10:47 am #Peter

    Thanks Jason.
    2 possible scenarios:

    1. I know this is far fetched, but could I build a house somewhere else with that money? I would sell the lot and then build my house in another lot.
    Is that possible? I had read somewhere that someone did that because they are replacing the house, not the lot and not necessarily in the same location.

    2. Another possibility, is to sell the lot, build the house by the new owner, show the cost of building it, recover the recoverable depreciation. Is that possible, since I’m the insured?

    I read both of those scenarios and both were found to be legit, but I’m not sure if those people had to file suit against the insurance company. The legal fees would be close to the loss so it would not be feasible.

    Any thoughts?

  1886. February 24th, 2015 at 6:05 pm #Jason

    Peter,
    Yes, build it elsewhere.

    Your #2 suggestion probably won’t fly. If you sell the lot to someone else, then improve their lot with a new building, you are doing all this for the benefit of the lot owner. There will be no recoverable depreciation available in this case.

    You could do #2 if you retained ownership of the lot, built the house, collected recoverable, then sold it.

    If you want more specific details about what is acceptable, talk to your adjuster and get their clarification in writing about what your options are.

  1887. March 3rd, 2015 at 9:17 am #Linda

    To recover the depreciation does the amount of repairs have to exceed the entire estimate or just the item that was depreciated? The repairs to the cabinetry in a water loss were double the amount of the estimate. The flooring was done in less than the amount of the estimate so the total repairs were actually less than the total estimate. We are only interested in getting the depreciation for the cabinetry, but were told it is based on the entire estimate. California.

  1888. March 3rd, 2015 at 3:02 pm #Jason

    Linda,
    You present a very interesting concern. I’m going to use concrete examples to present a response.

    Let’s say the RC (replacement cost) of your cabinets is $5000 and the amount your insurance company paid as ACV (actual cash value) is $2500.

    Let’s also say the RC of your flooring was $4000 and the amount your insurance company paid as ACV was $2000.

    If you replaced your cabinets at a cost of $5000 or more, you are entitled to the recoverable depreciation of $2500.

    If you replaced your flooring at a cost of $2300, your are not entitled to recoverable depeciation relating to flooring.

    You ask if the amount to which you are entitled is based on the total estimate or not. I cannot see how it is since each estimate item is specific to an item with its own stand-alone depreciation. I cannot find any case law or clarification of this for CA recoverable depreciation.

    If your adjuster claims it’s based on your entire estimate, please have your adjuster substantiate, in your policy, his claim that recoverable depreciation is based on your entire estimate. If he cannot substantiate it, you can bet he is making it up.

  1889. March 3rd, 2015 at 6:50 pm #david molettiere

    I had a oil co. delieved to my house , with the oil tank is located outside.The oil tank burst [exploded] due to overpressurization by the oil co. driver.Inow have oil sprayed onto the back of my house, and oil that went under my house, [double wide mobile home].This also created fuel orders that entered the house.who is responable , my ins. co. or the oil co. ins. co.my ins. co. sent out a consultant to inspect the tank, and now sending a engineer [tank corrosion specialist out to check the tank.THEtank did explode and released the oil. My ins. co. is saying this was a leak or spill.Iam at wits end ,iii do not know what to do.this happened on feb. 7,2015, and we are in a motel since then in which the ins. co. gave me a hard time even though it is my policy.

  1890. March 4th, 2015 at 10:41 am #Linda

    Jason,
    Thank you for your input! I was hoping I wasn’t too close to this situation to see it clearly, but your points are spot on with how I viewed it. I will pursue it further and let you know the results.

    FYI, the response they provided yesterday was this “Building damage claim amounts are handled as a whole claim as estimates are often slightly over or under in one area which off sets another. At this time, based on the invoices received, you have not incurred costs in excess of the payment made plus deductible so recoverable depreciation would not apply to this loss.” At the start of the claim they sent a letter explaining recoverable depreciation and gave examples of one item. There was no mention of total estimate amounts. The receipts we provided for all of the work done was well over the 1,000.00 deductible. The flooring was repaired where it was buckled, but there wasn’t enough money to do all the cabinets and complete the open area of flooring to match. We’re saving the remaining balance and expected to recover the depreciation to allow us to finish the floor. Frustrating, but I will politely pursue.
    Thanks!!

  1891. March 6th, 2015 at 8:07 am #Linda

    Jason,
    Just wanted to let you know that I followed your suggestion on the recoverable depreciation (3/3/2015) and asked the adjuster to substantiate, in the policy, the claim that recoverable depreciation is based on the entire estimate. I also pointed out that each line item on the estimate has it’s own stand alone-depreciation and that depreciation was not taken on the entire estimate amount.

    I received a reply that they “found a way to allow the depreciation payment”. The check is in the mail.

    Thank you!! I’ll be reviewing the material you have available for purchase.

    Linda

  1892. March 6th, 2015 at 8:59 am #Jason

    David,
    Based on the info. you provided, it appears your insurance company is responsible for the damage, unless the damage or the event that caused the damage is excluded.

    The oil driver may be liable, and also responsible for the damage.

  1893. March 6th, 2015 at 9:01 am #Jason

    Linda,
    It’s all your doing to convince your adjuster he needs to do the right thing.

  1894. March 8th, 2015 at 1:47 pm #Diane

    Hi. I had water damage to my home recently. My floors downstairs are hardwood. In the bathroom, and in one other spot, the floors are discolored from the water damage. The adjuster only wants to replace the wood in the bathroom and sand and refinish the remaining floors. They are all the same flooring. It would never match going forward. Do you think this is legitimate?

  1895. March 8th, 2015 at 2:04 pm #Jason

    Diane,
    It’s difficult to provide any feedback when you provide just a little bit of information. The adjuster saw the flooring and his proposal seems viable. If the most affected flooring is replaced and then all of it refinished, it should be fine. With the process you just mentioned, it should all look the same. I don’t know what you mean when you say it won’t match.

  1896. March 9th, 2015 at 5:47 pm #LYNN

    Liberty Mutual Ins. I have home owners insurance on my home. September 2014 to February 18th 2015 I had family members living in my home I had the water left on in my name and they were to have the power in there name. I was out of state until Feb 22nd I came home to cold weather and I stated the fire place to keep it hot. On the morning of the 23rd I had the power put back into my name. On the 24th I came home to find water damage and the ceiling had fallen in in the kitchen. The water damage was bad I couldn’t stay in the home. I contacted my insurance company by filing a claim using there online service and took pictures of the damage as they requested. And adjuster called on the 27th, during the first week of March a different adjuster came out he advised to contact a plumber asap and a company to dry the house out. As of today March 9th the work has began up front payment to the plumber was paid out of pocket the dry wall was pulled and cut outs removal of carpet and flooring has began. Today I get a call for the adjuster asking for the gas bill for Feb should I be concerned? Is their a possibility they wont cover me? What can I do to protect myself should I be alarmed?

  1897. March 9th, 2015 at 6:41 pm #Jason

    Lynn,
    Reading what you included and didn’t include in your post, you moved from your home in September. During the time your were gone, family members or you failed to maintain adequate heat in the home and obviously your plumbing system was not winterized. You said you came home to “cold weather” but it’s likely you meant you came home to an unheated home.

    Damage to the plumbing system between Sept. and when you returned in Feb. was unknown and undetected because frozen water remained in the pipes. Once heat was introduced to the home, the ice in the plumbing system thawed and water flowed from the plumbing system breaks and caused water damage to your home.

    I have no idea what you are talking about with your family members. Did they really live there? When did they move out? What did you do when they moved out? If you have family members move out of your home, you need to do some things to protect your home to keep your insurance coverage intact.

    The following is relevant language to your situation that is found in just about every single home owner policy sold in this country.

    2. We do not insure, however, for loss:
    c. Caused by:
    (1) Freezing of a plumbing, heating, air conditioning or automatic fire protective sprinkler system or of a household appliance, or by discharge, leakage or overflow from within the system or appliance caused by freezing. This provision does not apply if you have used reasonable care to:
    (a) Maintain heat in the building; or
    (b) Shut off the water supply and drain all systems and appliances of water.

    Based on the information you provided, the above policy language most likely applies to your situation.

    Your concern should have started in September so you could either winterize the plumbing system or make sure the home was properly heated during your absence. It is very probable you didn’t meet the policy requirements in order to maintain insurance coverage for your home’s current damage.

    No, you should not be alarmed. A loss like this is very preventable and insurance companies know this. That’s why they put a bit of responsibility on the homeowner so coverage remains intact. Your home needs to be repaired due to the water damage no matter what. It appears to be an expense you should not expect your insurance company to assist you with. Your additional living expenses probably won’t be reimbursed either since your loss is not a covered cause of loss.

  1898. March 10th, 2015 at 8:26 am #Jeff D

    Hi, I have a question… I am not to sure about.. I recently had a fire, most of the 2nd floor destroyed, and lost… the insurance adjuster claimed all the contents for the most part..

    My question is this, they came to a settlement amount for contents…Total amount, less depreciation.. I am working with them on the Depreciation portion.. But there are still items missing they did not include, and values for items purchased off..etc..

    The adjuster stated they wanted to pay me the balance of the claim due, that they came up with, but can still keep it open for further adjustments after, as things come up etc.. I told the adjuster I would prefer to finish what we have now prior…but they seem to be pushing me to take the rest of the money.. Even though it from what they say will remain open for further adjustments…it just seems odd, and wanted to know if this would in any way impact my other missing claims / disagreement to the contents settlement they provided?

  1899. March 10th, 2015 at 8:51 am #Jason

    Jeff,
    If there are missing items they did not include in your claim list, get those items listed now. Why would you not have them already included if you know there are items you have not yet listed?

    Get the replacement cost of the items to reflect accurately what it would cost to replace the items. Make sure everybody is in agreement with the applied depreciation too. This is the list, and its values, that are used to settle your claim. Sure it can be modified later but it is much more difficult to get changes later than it would be to have it correct at this moment.

    They want to keep your claim moving toward settlement and eventually closure. If they want to keep it moving, they will have an incentive to make sure it is correct right now so you agree with everything. Make sure all things are correct now and don’t rely on future adjustments.

  1900. March 10th, 2015 at 9:30 am #Jeff D

    Ok, I did include some of the items not listed, it was possibly inadvertently omitted…Also items not listed , i.e. clothing from a restoration company, list wasn’t on it either… I gave information on costs of certain items, but they made their own adjustments to these as well it seems on values.. So if I understand you correctly, get this worked out first prior to taking the balance they are wanting to give me… they mentioned if I didn’t accept, they would just send me a check? Forcing me to accept the money it seems..

  1901. March 10th, 2015 at 9:49 am #Jason

    Jeff,
    Get it worked out and hold the check until you both are in agreement. Your clothing is likely itemized with restoration company and accounted for. Your clothes should not be personal property destroyed since it is being cleaned.

    They can’t force you to do anything. Maybe they can wear you down so you eventually relent but don’t do that. Just make sure you are in agreement with your adjuster about everything. Just like they made changes to adjust your property, they can make other adjustments the other way if you persuade them to.

  1902. March 16th, 2015 at 3:56 pm #Ana

    Hi,
    we where away on vacation and had 2 friends house sitting pour property.
    One afternoon we get an email with bad news. Our furnace stopped working during the coldest day this winter, resulting in freezing and bursting all our vintage water radiators (cast iron) heaters, all around the house….resulting in damaging walls, floors, carpets and furniture. In addition to that our kitchen and bathrooms pipes also bursts.

    The insurance company was notified and took them 5 days to send out an adjuster, after the first adjuster visited the house and reported all the damages…for some reason they put another adjuster (a bad one) to take care of the case.
    This adjuster is only taking pics of the little things and the stuff he claims we are not covered. He only want to cover the smallest things like dry wall and 1 pump. We had to pay from our pockets for everything, including lodging.. more than 10K so far and the house still need work. It’s a month after the accident and the repairs are still work in progress.

    The new adjuster (the bad one) claims that our policy don’t cover cast iron or galvanize pipes or any damages that this may cause. Conveniently exactly what we need to be covered for!!!
    On his copy the part that say that “we are not cover for cast iron radiators etc….” it is conveniently in the last line of the paragraph. But when we look at our copy, it doesn’t say anything about that. That is not there..

    We confronted him saying that the copy we have does not say anything about that and that we never signed this new change in our policy. There is not initials or nothing showing that we accepted that change. He said that he will “investigate”…whatever that means.

    What can we do, we are desperate, we just want to get our money back… do we need to get a lawyer?

  1903. March 16th, 2015 at 6:12 pm #Bobbie

    We live in Southern California. We had a hot water leak below the foundation in our closet. The water went in the closet, on the other side of the wall in the hall, and into our downstairs bathroom. We have replacement value with our insurance company. The adjusters report showed the tear out and installation as 1 value. We asked why they were not separate. We asked for the breakdown of tear out and the breakdown of installation. The flooring was the same footage for both. We then asked why the installation did not include a 10% extra for waste. They told us that the system they use (Xactamate) only covers 10% extra for carpet and linoleum. Since we used a laminate we do not qualify for the extra 10%. We asked where in the code it states this. They made the statement that this is what it is take it or leave it. (the 10% difference would be approx. $4000.00) Is what they said a true statement or are they trying to cheat us out of $4,000.00

  1904. March 16th, 2015 at 6:25 pm #f michael conte,cpia

    Hi Ana,
    I would read your contract or policy and first determine if freeze up is a covered peril. I would then try to ascertain the claim settlement option you have either actual cash value or replacement value. it is hard for me to guess but it would seem that if you did not have replacement value they might be explaining in their own way that they will not replace the antique radiators. the insurance policy will clearly identify what is and what is not covered so with the info you provided I am only guessing, at best. If you bought this policy from an agent get him or her involved, if you are able you might consider hiring a Public Adjuster, they earn a fee for their work ,but at least you will get a professional working on your behalf.

  1905. March 16th, 2015 at 6:34 pm #f michael conte,cpia

    bobbie,
    what is the cost of replacement and what are they offering? if they are offering the cost to replace, then it would appear that you are being made whole, provided you can get someone to do the work for the amount they are offering. if you cannot find someone to do the work for the amount being offered then you should ask them to find you contractors that will do the installation for the amount offered.
    I would love to know the detail of this room size as it would seem to me that 40k would put down a lot of flooring.

  1906. March 16th, 2015 at 7:28 pm #Ken

    I am having a problem with my Landlord and his Insurance Adjuster.
    On Feb 17 2015 at 4:35 pm I went down stairs to find a water pipe had frozen and ruptured and the whole downstairs of my townhouse was under 2″ of water.
    I called my Landlord he told me there was a valve under the sink I turned the valve off and the water stopped.
    My landlord came by with a few towels and a mop and bucket, which would not help, after a few hours he went to Home Depot and bought a 16 gallon wet vac, and he vacuumed up as much water as he could from the kitchen Floor and the Family,Dinning, Living Room carpets, as well as the Bathroom floor. I took pictures and made a video, of the damage
    He claimed he Called his insurance Company and they had not called him back.
    I have renters Insurance and I called my Insurance company and opened a claim and told them I will report back if I have suffered a loss.
    Thursday Feb 19 2015 my Landlord and his Insurance Adjuster arrive about 7pm.
    he is looking over the damage to the Townhouse ground floor. His first remarks after viewing my video and pictures and seeing the damage to the Cabinets he stated the Cabinets need to be replaced.
    then he continues to say the carpets need to be replaced since they are continuous from the living room to the dinning room to the family room.
    he tells my landlord to call serv-Pro to do the drying process,
    they were scheduled to come that monday, but instead they came early friday at 9 am,
    the drying process ended Monday Feb 23 2015 in the late afternoon.

    the Landlord and his Adjuster again come back by this time he says they can save the cabinets however serv-pro knocked out a side and bottom of the cabinets to help with the drying process.
    today is March 16th 2015 and the kitchen is still as Serv-pro left it and I haven’t heard a word from the landlord, I closed out my claim to my insurance company since I did not suffer any loss. the only loss I have suffered is the useage of the ground floor, when serv-pro did their drying out process they cut the sheetrock 2 feet from the floor so now I can see the studs and duct, electrical wiring and pipes, there is insulation exposed
    my wife and I are forced to stay upstairs, We can’t use the down stairs, we can use the Kitchen but i’m uncomfortable to do so. My wife and I are disabled and we can not continue to live in this condition, I have also had to lock up my cat to our bedroom and he is no longer allowed to roam free, who do i complain to the landlord said he will not challenge the Insurance Adjuster, he also told me not to give my neighbor any info since he also suffered a loss.
    who can i call to light a fire under their behinds to get this going?

  1907. March 16th, 2015 at 10:09 pm #Jason

    Ana,
    I reiterate exactly what conte has said. From the intitial moment I read your post, I was concerned that you don’t actually have coverage. It is important to know that you don’t have freezing coverage unless you take specific precautions to prevent freezing damage.

    Pertient policy language you should be concerned about is as follows:

    2. We do not insure, however, for loss:
    c. Caused by:
    (1) Freezing of a plumbing, heating, air conditioning or automatic fire protective sprinkler system or of a household appliance, or by discharge, leakage or overflow from within the system or appliance caused by freezing. This provision does not apply if you have used reasonable care to:
    (a) Maintain heat in the building; or
    (b) Shut off the water supply and drain all systems and appliances of water.

    Since you didn’t mention you took these actions, and only had friends house sitting for you, I assume there you have no coverage unless you provide clarifying information.

  1908. March 16th, 2015 at 10:14 pm #Jason

    bobbie,
    I agree entirely with conte and you should follow his advice. I also want to add that there is an allowance waste for linoleum flooring and carpeting. With laminate there is not a waste factor. If there is not a waste factor allowed for your flooring, then your contractor needs to rely on very little to no waste in the floor installation.

  1909. March 16th, 2015 at 10:32 pm #Jason

    Ken,
    Nobody. If you don’t like the situation of this accidental incident and the recovery process, you can move. That is your only remedy. You can light a fire under youself to prompt your move if you don’t like what’s going on. Other than that, you have no control or influence over the process because you are not involved in any part of the repair process.

  1910. March 18th, 2015 at 5:53 pm #jeremy

    Made a homeowner’s insurance claim for what I thought was a broken sewer pipe under my house. Insurance booked a hotel for my family as we were concerned for our health, my son was sick and I assumed there was correlation there. Mitigation company was dispatched by the insurerer, completed pump-out and nuetrilization of affected area. Given the time of year and local weather it took two days to get a plumber out to look at the pipe. Plumber said sewer line is not broken, water in crawlspace is ground water and the horrible odor was the result of a previous conditition. Ground water removal is not covered by my policy. How should I present this information to the insurance company? Moreover, while I understand that I’ll likely have to pay the bill for the hotel, should I be responsible for the mitigation costs given that a) they went ahead with the work without verifying the cause and b) I was unable to compare rates or direct scope of services? Also, can I be punished or accused of fraud in this situation? I appreciate any help in this matter, feeling completely lost/confused.

  1911. March 18th, 2015 at 6:54 pm #Jason

    jeremy,
    You had to have the work done at your place no matter what. Once the work is done, it’s too late to get other estimates. Why present the information to the insurance company if you know it’s not covered?

    I don’t know why you ask about fraud. Did you commit fraud or something?

  1912. March 18th, 2015 at 7:47 pm #jeremy

    OK, perhaps I was unclear. I went under my home and detected what I understood to be raw sewage. After a bit of digging I found water to be seeping from area around sewer pipe. I assumed the line was broken. Based on that information the insurance company initiated a claim as I stated in OP. The plumber did no work as there was no break, the water was ground water passing over soil that may have had sewage left from a previous leak, as evidenced by previous repairs having been made. At this point I do not have a claim, I know that, but based on my information, and at my agent’s urging, a claim was initiated and they’ve already made arrangements, I know I haven’t committed fraud, Jason, I just don’t know how to proceed given the findings of the plumber. Thought I might find advice or help here, not accusations.

  1913. March 19th, 2015 at 2:54 am #Nathan

    Can I, as a Liscends Public Adjuster in oklahoma stop the small town insurance agent from showing up to my adjuster appointments, and speaking with the actual insurance adjuster and or the home owner about me my company me my service false past accusations from other claims of his policy holders. Before and during the inspection? That is a laundering my name.like i get people approved and don’t do their work. Is thier a oklahoma statute against this or is it a internal polish for statefarm to handle.

  1914. March 19th, 2015 at 5:39 am #Jason

    jeremy,
    You have a claim open, so let your insurance company investigate whether or not it’s covered. They know more about your policy and your coverages than you do. I can’t tell if the condition is covered or not based on what you provided so let the claim proceed to the end. Making a claim isn’t an act of fraud. Fraud would involve more than just making a claim. (Please note that a question doesn’t amount to an accusation.)

  1915. March 19th, 2015 at 5:49 am #Jason

    Nathan,
    I don’t know how you would get around your concerns with the agent. I don’t think you can force someone not to show up at meetings they are allowed to be at by their insured.

  1916. March 19th, 2015 at 5:58 am #jeremy

    OK, thanks Jason… I’m obviously new to this and I appreciate your promptness in responses (I was expecting to wait days for a response). I’ll speak with the insurance company today. They were great in getting us out of the house immediately as we suspected our health was at risk, so hopefully they’ll be understanding in my misdiagnosis of the problem. I doubt this is a common issue because the cause of damages are usually obvious whereas this one was not. Thanks again, I’ll repost when this matter (mess) is resolved.

  1917. March 26th, 2015 at 8:20 am #Sarah

    We moved into the home a year ago after a thorough home inspection which revealed no issues with the roof or moisture issues in the attic of the home. We had a hail storm several months later and nearly every other house in our subdivision had the roof replaced. We began having leaking through our downstairs window after the storm starting as just dripping but progressing to needing buckets to collect. We had the window replaced. When the window still leaked we had insurance come out and look at our roof to assess for hail damage. They claimed only cosmetic issues and denied the claim for a new roof (they also denied the claim on the duplex that we own and rent out even after the insurance for the owners in the other half of the duplex approved theirs). We later found significant moisture and rotting wood in our attic. We reopened the claim and then adjuster came out but the weather was too bad to have a roofer out. They just returned with the roofer yesterday and only evaluated the roof on the outside, not the attic. They determined that the shingles on the dormers of the roof were improperly installed and that was causing the leak for the window but not the moisture in the attic. They claimed no hail damage and said nothing was covered because it was improperly installed- esentially indicating this roof had been leaking for up to 13 years now. My husband and I still think that this does not make sense given the timeline of what we know. We do not want to give up on this claim. Does this sound fishy and what are we able to do?

  1918. March 30th, 2015 at 7:42 am #Sarah M

    Hello,

    We have been covered for our house insurance in Massachusetts (the insurance got paid in full for the year when we closed on the house) and we didn’t receive the physical policy document until a couple days ago. When we inspected the document it had the wrong address covered under our insurance policy. Would we be justified in requesting a refund for all the months that our property was not insured, since it was the wrong address (not even owned by us) insured?

    Thank you!
    Sarah M

  1919. March 30th, 2015 at 7:53 am #Jason

    Sarah,
    No, it would not be reasonable to ask for a refund because there was an incorrect address on your policy declaration page.

    The option and responsibility you have at this time is to notify the insurance company of the correct address so it can be changed.

    Regardless if the wrong address was shown on the declaration page, all other things relating to your insurance support your actual home was insured despite the address error.

  1920. March 30th, 2015 at 8:05 am #Sarah M

    Thank you for your prompt reply.

  1921. March 30th, 2015 at 2:24 pm #Julie M

    Hi my 7 year old fell while visiting his dad two stories when he was 4. he didn’t tell me and went to a walk in, it was an accident buT this past January I noticed my sons back and hip looked funny and he’s been diagnosed with scoliosis( quite significantly can’t for his age) it’s not confirmed yet but the specialist feels the fall may have caused it…I don’t believe his father told his homeowners about the fall, if the fall did cause this is this an issue if I try to get restitution for my sons injuries?

  1922. April 2nd, 2015 at 4:48 am #Kim

    Hi, an adjuster came out to my home for damage I received a check for $4,000 I called them and told them that was unacceptable. I got the name of a contractor THEY use but they are on the level as their estimate was substantially higher than the adjusters. The contractor is sending the estimate and the bills to the insurance company directly. Can I still cash the check for any additional loss that they are not covering (ie Fence, pool etc)
    Thank you -Kim

  1923. April 2nd, 2015 at 8:27 am #Jason

    Kim,
    Is your contractor requiring a down payment at this time that you need to cash the check?

    If your loss doesn’t provide coverage for your fence, pool, etc. why would you need to cash the check for those items? You would need to pay for the fence/pool using your own funds, not insurance funds.

    If there’s a future adjustment, it will be made by issuing an additional check.

  1924. April 2nd, 2015 at 2:04 pm #James Goodman

    The claims adjuster and contractor gusher over how great Xactimate was in providing a fair cost estimate. I had the claims adjuster break out the component cost of the Xactimate estimate. I wanted to use the material allowances to purchase items for the contractor to install. Now the contractor is telling me I can’t do that. I’m told the contractor has to buy all the materials and mark it up to arrive at my cost.

    When I compared the local labor rates for a carpenter for example I found the all in rate of all labor cost components to be $34/hour the Xactimate cost is $64/hour there seems to be a $30/hour cost to cover “other cost” and/or gross margin. This combined with 20% O&P seems to be very generous to the contractor. In light of these facts why can’t a home owner go to the local big box hardware store and purchase materials using the allowances in Xactimate?

    The contractor is also telling me the Xactimate is only good for the total amount of the claim. The contractor will work with me to obtain like kind and quality and make the total dollars fit. This sound a little unethical if not fraudulent. Am I crazy or what? I could be crazy, but if I am please explain why. Thanks James

  1925. April 2nd, 2015 at 4:20 pm #Jason

    James,
    Yeah, you are crazy. Contractors are a special breed and don’t want the homeowner getting in their way. By you suggesting you are going to get the materials, you are messing up how he does business every-single-time.

    In fact, some contractors charge more for their work (to the homeowner) if the homeowner helps with labor. That is because homeowners get in the way and lower the efficiency of the repair process.

    Another option is to just purchase your materials at your big box store and do the repairs yourself.

  1926. April 2nd, 2015 at 4:29 pm #Jason

    Julie,
    Why would the apartment pay for anything for a fall of this nature? It seems the one that should have been watching your son is his father. If the walk-in office visit is paid, then it is already addressed.

    Scoliosis does not require a fall to develop. It’s going to be nearly impossible to tie the fall direclty to the scoliosis. It doesn’t sound promising and it may not be worth your time to pursue. Talk to an attorney for specific advice.

  1927. April 7th, 2015 at 3:54 pm #Dennis

    I recently found out I had wind and hail damage to my roof that occurred in May of 2014. Last year, after growing tired of premium increases due to a small claim submitted about 3 years ago, I decided to switch insurance companies. This would have been the only claim I ever submitted in 14 years of owning the policy. I left Motorist Mutual for Farmers Mutual in September of 2014.

    I live in West Virginia. I understand I have one year from the date of the storm to file a claim for the damage. My question is can I go back at Motorist Mutual and file a claim even though I have cancelled my policy with them?

    Your help is appreciated.

  1928. April 7th, 2015 at 4:00 pm #Jason

    Dennis,
    Two things here:

    1. Yes, immediately file a claim with Mortorist Mutual for your storm damage

    2. Immediately find a different insurance company other than Farmers. Farmers ranks very high in claim customer disatisfaction.

  1929. April 9th, 2015 at 9:56 am #ariel

    hi there was wondering if you have no mortgage, filed a claim – pipe burst, and the insurance company sent out 3 checks, one for dwelling, one for personal property, one for part of actual loss, Am I required to make ALL of the repairs they paid for? replacement of tile, remove and replace kitchen due to tile replacement, etc.

    They paid for bathroom remodel (which was a pipe burst) this is the repair we are doing right now.

    however, They also paid for complete – continuous tile replacement, because they could not locate the tile, around the pipe burst, so as a result the paid for entire home retile and resulting damage due to retiling.

    I am really not interested in going through the nightmare of retiling the entire house and simply wanted to restore the bathroom, repair the pipe and remodel the bathroom where the pipe burst. Would this being restoring the home to repaired condition and sufficient or could this lead to a problem? are ALL the “paid for” replacement of the items they paid mandated /required?

    . Again there is no mortgage and they already sent me 3 rather large checks which was shocking. I am not sure if I am forced to do ALL repairs beside the correction of leak and bathroom. Everything else is simply aesthetics

  1930. April 9th, 2015 at 10:12 am #Jason

    ariel,
    You as the homeowner decide how much of the repairs you want to make.

    Since the insurance company paid for the rest of the continuous floor to be replaced, if you have a future loss to that portion of the flooring you did not replace, your insurance can rightfully refuse to pay for any future repairs (to the flooring you did not replace) since they already paid for its replacement once.

  1931. April 9th, 2015 at 6:41 pm #Ariel

    Thanks for your response Jason. So your thoughts are that it’s up to me what repairs to do? With the implication that they can refuse future claims based in continuous floor? They also put us in alternative housing for a couple months while repairs are complete. If I only do bathroom I would assume it will shorten length of stay. What are your thoughts on loss if use payments? They made one months payment upfront and two payments are pending.

    Do they have the right to inspect and should I simply state that I’m not doing the floor , or may that create a problem

  1932. April 9th, 2015 at 7:30 pm #Carol

    I recently bought homeowners and car insurance from Ameriprise through Costco. I paid the annual premium at the time of purchase. I just received a notice that my homeowners insurance will be canceled in 3 weeks because they have determined I live to close to brush.

    First of all LA county assesses me almost $1000 a year via my property tax for bush abatement services they perform twice a year, secondly there is very little risk associated from a brush fire because the roof is cement tiles and the house is stucco and thirdly there has been no history of brush fires in the area that I live.

    Is there any way for me to appeal their decision? I would be grateful for any suggestions.

  1933. April 9th, 2015 at 7:38 pm #Jason

    Ariel,
    It’s not my thoughts in the slightest – It’s the fact that you do whatever you want with your repairs. It’s your home. It’s your castle. Nobody makes the decisions about your property except YOU.

    Use the loss of use as needed. Don’t abuse it. You, like everybody else, have a conscience.

    No, they don’t have the right to inspect since it’s your home. You authorize and allow only who you want to enter your home. (I don’t know why people don’t think and understand that they have total domain in their homes.)

    You don’t have to tell them a thing about your repairs. It’s entirely in your hands now.

    If you value your insurance company, remain with them. If you have allstate or farmers, consider switching to a better rated insurance company.

  1934. April 9th, 2015 at 7:45 pm #Jason

    Carol,
    Talk to your agent and find out what can be done. If you don’t have an agent – get one.

  1935. April 10th, 2015 at 6:44 pm #Ariel

    Thank you Jason, just wanted to make sure there was nothing wrong with taking their check and doing the main repair only. Because if the amount of the check I am a bit concerned about what my obligations are . But they haven’t had me sign a thing.

    One last question about the loss of use, can they use this as an excuse to inspect? Can I simply say no, how will they be able to verify how long I need loss if use for?

  1936. April 10th, 2015 at 6:52 pm #Jason

    Ariel,
    They really have no business being in your home. You either let people in your home willingly or they don’t enter. It’s pretty simple.

    They will know pretty much how long you need loss of use. By you communicating with them how long you need and letting them know when you no longer need it. Just keep them informed and make sure you and they know what’s going on as far as your loss of use. If you need a week, let them know that is what you need. If you need 2 weeks, let them know that is what you need.

  1937. April 11th, 2015 at 6:43 am #Ariel

    Jason you seem very knowledgable in the area. Your not an attorney ? I can find bio anywhere?

    Still a bit confused about depreciated values. I had a scope of loss estimate provided to me and it seemed fair. They paid based on that estimate by an imdeendant .Is that the norm? Is it safe to say that once they pay major amounts like that they won’t ask for the money back, claiming investigation or anything else? How do I know the true outcome. It simply seems like they paid based on scope of loss period. Was expecting a fight over every last thing. Offcourse they denied one major thing but paid all the rest. Seems to good to be true

  1938. April 11th, 2015 at 7:20 am #Jason

    Ariel,
    I am not an attorney.

    Many times independent adjusters write estimates and insurance companies rely on those estimates to settle a claim. That seems to have what happened with your claim.

    Your insurance company accepts the submitted estimate as the basis for your claim and they paid based on that. There is nothing here that would indicate they would ask for any of the money back. Insurance companies, for the most part, don’t ask for money back.

    Nobody should have to fight to have their claim damage paid for by their insurance company.

  1939. April 14th, 2015 at 2:43 pm #ariel

    Jason,

    1) What are the chances that an insurance company would sue you for return of funds due to lack of repairs being done or inflation of claim? I would think they wouldn’t pay it if the claim is under investigation ? If they pay, then its a covered loss or could they change their minds later – and think inflation …etc.

    2) I have seen the”notice of intent to repair” forms being required of people and wasn’t sure why were weren’t ask to sign anything prior to large payout. They sent the checks and we didn’t sign anything. Seems strange

    3) Are they obligated to provide us with loss of use no matter how long it takes (as long as we don’t go over the amount of coverage total)? . An example would be replacement materials not being available or construction delays? If I ask for more time, i give the explanation and this should suffice for extension of ALE and payment reimbursement?

    thanks so much your answers are amazing!!! The best info out there.

  1940. April 14th, 2015 at 3:00 pm #Jason

    ariel,
    1. Nearly zero. On second thought, actually zero. Usually an investigation takes place before the claim is paid. Insurance companies can change their mind anytime during their investigation. It’s really too late once payment has been made.

    2. I don’t know to what you refer when you refer to notice of intent.

    3. No, loss of use is dependent upon each individual claim. ALE is probably the most flexible coverage within a homeowner policy and a lot of common sense needs to be applied when it is used. If your explanation is reasonable to the claim adjuster, it should be acceptable.

    If replacement materials are not available, go with something else. That isn’t a reasonable reason for delay. There should not be any construction delays. Any competent repairer should be able to do repairs within a reasonable amount of time, and that amount of time should be easily pre-determined.

  1941. April 15th, 2015 at 9:59 pm #Robin

    Our home burned down recently in a California wildfire. We decided to purchase another home in a different location instead of rebuilding. Our insurance company is telling us that we can only use the insurance money toward the dwelling portion of the new home and we have to pay for the land portion ourselves.

    We will have to take out a mortgage to pay for the land portion of the new home because the lot where our old home was is now worthless so we can’t sell it. This doesn’t seem fair. We will now be in debt and have higher property taxes than we did before. Our only other choice is to rebuild at our current location, where we will be unlikely to find a buyer if we ever want to move due to the destruction to the area caused by the fire.

    Our neighbor was paid the limits of his policy, including the extended coverage without even having to buy another property or rebuild. Why is our insurance company treating us so differently? Is there anything we can do? Thanks.

  1942. April 15th, 2015 at 10:25 pm #Jason

    Robin,
    That is correct about what your insurance company is telling you about the land and improvements upon the property you are buying.

    It is contrary to your conclusion that the land portion of your loss is worthless because it is not. It remains as valuable as it did just before the fire. Your comment and conclusion about property tax is incorrect.

    Your insurance company doesn’t guarantee your home will sell whether it is at location A, or location B. That’s not what insurance does.

    I don’t care about your neighbor or what his insurance company is doing. I don’t know the parameters of his coverage and neither do you. Your insurance company is treating you exactly as they should under a normal homeowner policy.

  1943. April 17th, 2015 at 2:39 pm #Robin

    Justin,

    I have to disagree with you that the land portion remains as valuable as it was before the fire. The market value of the land is based on what a buyer will pay for it. Since there were 7,000 acres burned in the fire, the entire area looks like a war zone. I very much doubt there will be a hot market for property in the area for years to come.

    My comment and conclusion about property taxes is correct because in order to get the entire payout up to the extended policy limits we have to by a $650,000 property ($500,000 for the dwelling + $150,000 for the land) vs. a $500,000 property if we could use the proceeds for the purchase of the land and dwelling. A difference of about $1500 a year in California.

    Even should we choose to buy a less expensive dwelling, say $350,000 for the dwelling and $150,000 for the land, we still have to take out a mortgage for $150,000. An expense we did not have before the fire.

    I understand that the insurance company doesn’t guarantee our home will sell whether it is location A or B. I included that information to explain our reasoning for not wanting to rebuild in the same location. In California, Ins. Code. 2051.5 was instituted to help victims of disasters relocate if they choose, but because of the way our claim is being handled, we probably will not be able to afford to relocate.

    Whether our not it is the way insurance companies work, it certainly does not seem equitable. Why does the insurance company care whether we buy a $500,000 house or a $650,000 house? It’s the same amount they are paying either way.

  1944. April 18th, 2015 at 1:05 am #Jason

    Robin,
    Your land remains the exact same size as far as acres as before the fire. It was suitable for a house before and it is suitable for a house right now. I did not say your lot is as valuable now as it was before the fire. I don’t measure market fluctuations and your insurance company does not guarantee your home’s market valuation. In fact, your insurance company doesn’t even insure your land. Your land is expressly excluded as an item insured by your homeowner policy. For you to expect your insurance company to be concerned about something they don’t even cover (your land) is obscene.

    You mentioned 7000 acres burned. Just for clarification, it doesn’t matter if 7 acres burned or 7 million acres burned. That is not relevant to your loss. In reference to “hot market”, if I didn’t already reference this, your insurance company does not insure for market fluctuations. They never have and they never will.

    Just like your insurance company, I don’t care if you buy a $10 million dollar lot and a $1 house or a $1 dollar lot and a $10 million dollar house, it is meaningless to the insurance company. The insurance company doesn’t care about the market conditions – only the replacement cost of the improvements upon the lot. Much like your insurance company, I don’t care if you take out a mortgage in reference to your property or not – mostly because that is a personal choice.

    In regard to California, Ins. Code. 2051.5, you are incorrect. This has nothing to do with insured persons who are involved in a loss. It has nothing to do with relocation since insurance has nothing to do with relocation. Relocation is entirely up to the home owner. Your claim is being handle correctly but you refuse to accept the limitations of you situation.

    I don’t care if it “seems” equitable or not, that is how insurance works. If you don’t want to be bound by the terms of an insurance policy, all you have to do is simply not enter into an insurance contract via an insurance policy.

    The insurance company doesn’t care if you buy a $20,000 trailer house or a $499 million mansion. It will charge a premium based on their actuarial exposure and experience.

  1945. May 3rd, 2015 at 6:27 am #Michael Connaughton

    Dear Sir,

    The California Department of Insurance has specific requirements for a public adjuster’s contract. With that California approved DOI contract, can a public adjuster be discharged at any time just as California law allows discharge of an attorney with the knowledge that the public adjuster like the attorney, is entitled to payment for services rendered up to the time of dismissal, including his time, any expert fees that he has incurred and all expenses incurred associated with the file?

    Thank you,

    Michael Connaughton

  1946. May 3rd, 2015 at 6:40 am #Jason

    Michael,
    That is a legal question, not an insurance question. You may want to consult with an attorney.

  1947. May 4th, 2015 at 7:42 am #Zach

    My wife left a pot on the stove last night and when we returned home and opened the door the smoke smell engulfed us. It was not thick some but the smell was unbearable and I carried the pot outside and then opened all the windows. We tried vineger, febreez etc but this morning it is still smelling in certain areas and all our clothes in closets, bedding etc all smell. Would my home insurance(condo) cover the cleanup for this? All that is evident is the smell and we did call the fire deparment to ask about possible poisonous gas but they mentioned to just air the house out and clean the carpets etc.

  1948. May 4th, 2015 at 6:14 pm #Jason

    Zach,
    Yep, Fire and smoke are covered causes of loss. Get your insurance involved since it’s a way larger loss than you originally thought.

  1949. May 7th, 2015 at 7:56 am #Amy

    Dealing with insurance and Ice Dam damage…nightmare. Demo is now complete, damage was EXTENSIVE. Getting final estimates approved through adjuster and insurance carrier. However at this point they are saying that the roof is not being considered, since “ice dams don’t damage the roof” and although they are agreeing to replace window casings, stools and aprons, they are NOT covering the windows themselves which seems kind of stupid. How can i push back on the insurance co effectively on this to get the windows covered at least. I’ve got to send back the proof of loss form but, want to make sure that does not prevent me from pushing back on this item.

  1950. May 7th, 2015 at 12:25 pm #amy

    btw – i do have broken glass in numerous windows from falling ice. Can i at least push hard to get those repaired? Or should i really push for replacements? a good amount of the damage resulted from these same windows filling up with ICE and that then dripping down through the walls.

  1951. May 7th, 2015 at 7:01 pm #Jason

    Amy,
    I don’t know how to address you concerns. You indicate ice damming and then later you say falling ice caused the windows to break. It’s one or the other, unless you’ve filed two separate claims. Are you telling me double pane windows filled with ice? Ice, no matter what cannot fill a window. Perhaps water filled the window and then that water turned to ice?

  1952. May 7th, 2015 at 10:56 pm #Bobby

    Hi, I recently had a small kitchen fire in my home. While the extent of the damage from the fire was minimal, the smoke got everywhere. My question is in regards to my electronics. I’ve read that smoke and soot can seriously deteriorate the electrical components over time. Most of my larger electronics, like my TVs, are new (only 2 years old). I’d like to get them replaced to avoid any issues in the future. Also, I’m worried that any warranties I have may be void now. What would I need to do or provide to the insurance company to get new electronics (TVs, computer, tablets, game consoles, etc.)? Also, would this apply to a lot of the small appliances in my kitchen (blenders, toaster, etc.)?

  1953. May 8th, 2015 at 3:35 am #Jason

    Bobby,
    Get the source of information where you read smoke can seriously deteriorate electrical items and ask your adjuster to replace your items after you present that source to him.

    Insurance is designed to cover damage that is both accidental and sudden. In your description of the possible damage to your electronics, you said “over time”. The possible electronic damage may be accidental but it is not sudden. Your policy specifically excludes wear and tear and deterioration. Deterioration is another word you used to describe the possible damage.

    Perhaps your adjuster may consider cleaning the electronic items because they may have a smoke odor.

  1954. May 8th, 2015 at 5:34 am #Amy

    Jason – very simple, ice dam on roof = large icicles hanging on house…falling icicles = broken windows.

    These are single pane original windows and with the insane winter we had in New England there was similar damage to many homes. I woke up one morning and there was about 4-6″ of ICE inside the window between outer storm window and inner window. clearly the melting ice from the dam, came in through shingles and down through window frame/wall and then refroze. I had this going on in at least 6-8 windows in the house….how can the insurance co not replace these windows?

    New England extended day hotels are FULL of people who are displaced due to ice dams, I am sure insurance companies are overwhelmed dealing with these claims and trying to minimize their losses, but, i want to make sure what can be fixed is fixed right.

  1955. May 8th, 2015 at 6:02 am #Justin

    Hello All,

    I had a LARGE tree fall on my property about 50 feet behind the house. It shook the entire place pretty good. Now I am noticing that the house foundation has a crack I never saw before (and was not on the inspection report less then 1 year ago).

    What types of damages caused by this would typically be covered by a homeowners policy based on the tree not hitting the house?

    Thanks,

    Justin

  1956. May 12th, 2015 at 3:09 am #From Ohio

    My parents home recently burned and is a total loss. If they have paid for $450k of structural coverage, why would it be acceptable for the insurance company to say the payout will now be $300k? They’ve paid the premium for $450k in coverage for 20 years based off of what insurance said it would cost to replace. But now they say it’ll be less. Doesn’t seem right to me. Please advise.

  1957. May 12th, 2015 at 8:25 pm #Renee

    Recently we had roof damage that lead to leaking into our garage. It was due to bad storms. We called our insurance agency who sent their adjustor. We were told to get to estimates. We did. One was for 7,000 and one for 6,000. Both wanted to fix the roof, put new shingles on the garage and fix the ceiling in garage by changing the drywall, and fix the side wall of garage where it is leaking. They called today and only will offer 1500.00. He also told me that the side wall issues won’t be covered cause it was caused by heavy snow on it or freezing rain and then it caused a issue with the flashing which let in the rain. Told me my policy didn’t cover snow, ice, sleet, etc. I told him so if we get a snowstorm and a pile of snow is on my roof and it collapses it isn’t covered…knowing he was lying and he said no. I went through my policy tonight and it does cover roof damage from snow, ice, freezing rain, etc. so what do I do? He said he knew for sure the one damage was from storms but he couldn’t prove the flashing was from storms cause there was no dents, etc so he insists winter storm…..

  1958. May 12th, 2015 at 8:33 pm #Renee

    We had an adjustor come out for our roof and interior of garage damage. The ceiling is side walls are leaking and the shingles and flashing are messed up. The estimates are 6100.00 and 7000.00 that we got. to repair the roof shingles and fix the ceiling drywall and the side wall of garage. He informed us today that they will not pay on the side wall that he thinks that one incident was caused by a storm and that the other must have been caused by winter damage to the flashing which then caused leaking in the storms cause he doesn’t see wind damage to the flashing. He then said they will only pay 1500.00 and that they aren’t covering the side wall damage cause my insurance doesn’t cover winter weather. It is a MHO2. I looked up my policy and it does cover winter storms, freezing rain, etc that causes damage. What do I do?

  1959. May 13th, 2015 at 9:04 am #Jeff

    I had a hot water pipe burst in a vacation home that ran for what we figure was over a week. I’m worried that any appliances with motherboards would be adversely effected by the steam in the house (the temperature in the house was 20 degrees above the thermostat setting when discovered.) I’m also concerned about upper kitchen cabinets that seem to have been somewhat effected by the moisture in the air are not in the mix for the adjuster because they were not immersed in water. This is much different than a cold water pipe breaking. Any advice?

  1960. May 14th, 2015 at 9:10 am #Linda

    We filed a claim with our insurance in 2013 when our washing machine overflowed for about 6 hours. We used the restoration team the insurance adjuster recommended and things seemed to go smooth. This year in march 2015 we were having our central heat and air unit replaced the company went to install new heating unit and found that the venting below had collapsed. He asked if we had ever had water in the garage and we told him about the washing machine which sits on the other side of the wall in utility room. Our garage is about 2-3 inches lower than house. Heating guy said water from washing machine ran down the wall into the vent under the heating unit and that is why whole garage wasn’t flooded. This claim should be supplemental to the one filed in 2013 because the restoration company overlooked the garage and said not to worry about it because it would dry on its own because floor was concrete.
    Insurance company is now giving us a hard time. We tried to do everything right by using company they recommended. They couldn’t even get paperwork from restoration company and I provided them with that. Do I have a leg to stand on?

  1961. May 14th, 2015 at 3:37 pm #Jason

    From Ohio,
    I did some research into why a settlement offer in Ohio would be about 3/4ths of their coverage limit. I found that Ohio is a valued policy state. That means the policy limit will be paid in the event of a total fire loss. If the insured doesn’t rebuild on that property to replace the home, the insurance may pay a different amount. Perhaps your folks can ask their adjuster why that offer was made.

  1962. May 14th, 2015 at 3:58 pm #Jason

    Renee,
    Roofs are built to withstand bad storms. Bad storms are not a cause of loss that is covered by your insurance policy. You didn’t provide enough detailed information to make a reasonable response about what you should do.

    I don’t know to what you refer when you mention MH-02. What is that?

  1963. May 14th, 2015 at 4:05 pm #Jason

    Jeff,
    Your worry is unfounded. Insurance doesn’t provide coverage based on temperature or humidity fluctuations. Since temperature and humidity fluctuations are normal occurrences, any perceived damaged to your motherboard and/or cabinets from these alleged conditions is not an insurance concern. Your homeowner policy covered direct damage from covered perils (causes of loss).

  1964. May 14th, 2015 at 4:35 pm #Jason

    Linda,
    Using a a company someone recommends is not doing things right. You need to make your repair decisions on your own and not rely on others who have no ownership interest in your home.

    The time between your 2013 claim and this newly discovered damage may be too long of a time span. Just because your heating contractor proffered his opinion on currently discovered damaged doesn’t mean that is the actual way the damaged condition happened.

    I don’t have enough information (other than the approx. time between 2013 claim and this new discovery) to say anything encouraging.

  1965. May 15th, 2015 at 3:48 am #From Ohio

    Interesting, thank you. I’m sure it’s all tactics of some sort. Does valued policy law cover the contents portion as well?

  1966. May 18th, 2015 at 7:39 pm #From Ohio

    So when asking the adjuster about the valued policy laws he said “Ohio does not enforce that law”. :/

  1967. May 19th, 2015 at 4:45 pm #Deborah

    We filed a claim recently with CSAA for damage around a burst pipe in our bathroom wall. The “field claim specialist” came out and assessed damages at $14,000. Meanwhile, CSAA has informed us it will not be renewing our insurance due to a claim filed by our neighbor for bamboo encroachment on her property last year. (The bamboo was removed, a chemical barrier was installed, but not on our property, just the neighbors). So my question is, can they drag their feet until the policy expires, and then not pay the current claim? As far as I know, it has not gotten final approval.

  1968. May 19th, 2015 at 8:26 pm #Jason

    From Ohio,
    You are absolutely correct – Ohio doesn’t enforce any laws unless asked to enforce them. In this case, it appears you will have to file a summons and complaint and ask the court to enforce the law.

  1969. May 19th, 2015 at 8:36 pm #Robert

    Hi,
    I live in California and recently had a fire in my home. My insurance company moved my family & I to a hotel 10 miles away from our town. My wife and I must make the round trip every day for work and school (we have 2 school-age children). My question is, will we be able to get reimbursed for mileage, gas, etc?

    Thanks, Robert

  1970. May 20th, 2015 at 6:30 pm #Jason

    Robert,
    Explain the situation to your insurance company and ask your insurance company if you are able to be reimbursed.

  1971. May 21st, 2015 at 7:26 am #Kim

    My ex filed a claim for our roof back in 2007. He never used that money for the roof. Since then our mortage company has changed as well as the insurance. I got the house in the divorce falling down and all.. But now the roof is in extremly bad shape. Can I make a claim on the roof? I am worried it will come back on me and I will be introuble. HELP!!!

  1972. May 21st, 2015 at 9:40 am #fm conte

    If you were paid for a claim and never repaired the damage it sounds like you will be submitting the same claim a second time. If this is the case, you may not legally get paid twice for the same claim.

    fm conte ny ny

  1973. May 21st, 2015 at 10:34 am #Justin

    Somehow I got missed…. Does anyone know the answer?

    Hello All,

    I had a LARGE tree fall on my property about 50 feet behind the house. It shook the entire place pretty good. Now I am noticing that the house foundation has a crack I never saw before (and was not on the inspection report less then 1 year ago).

    What types of damages caused by this would typically be covered by a homeowners policy based on the tree not hitting the house?

    Thanks,

    Justin

  1974. May 21st, 2015 at 10:38 am #fm conte

    If it didnt hit the house i see no way of corrolating the two.

  1975. May 21st, 2015 at 8:40 pm #Jason

    Kim,
    Make a claim. That is about all you can do. Either it is accepted or it is denied.

  1976. May 21st, 2015 at 8:48 pm #Jason

    Justin,
    No damaged would be covered. Generally foundations are not an insured element of your home regardless of the cause of loss.

    A fallen tree would trigger little if any coverage – especially is downed by wind.

  1977. May 21st, 2015 at 8:53 pm #Jason

    Deborah,
    They should be able to process your current claim despite any other activities you are doing.

  1978. May 25th, 2015 at 11:00 am #Luis

    Hello I got a bit of an odd one and wanted to see if anyone knows the answer. I recently purchased a 3 family property through a short sale. I did an inspection and walk through with contractor. After closing I found out there was pipes that burst in the basement before the closing. The basement was dry the day of closing so I never noticed it at all. I found out from town I Spector that there was 4 feet of water in basement which damaged all three boilers and water heaters. Also with all the damaged pipes it’s gonna cost a lot of money. The closing was on 4/15/15 and the damage occurred on 2/19/15 according to town inspector. My question is can I go after the previous owners homeowners Insurance since it happened during that policy period?

  1979. May 25th, 2015 at 11:52 am #Jason

    Luis,
    Don’t assume the home was insured during the pipe break and water damage event. You however, can assume that they didn’t live in the home at the time, didn’t winterize the plumbing system, didn’t maintain heat to avoid the pipe break/water damage, and probably had no insurance.

    Let’s just say they had insurance when the damage occurred. If they didn’t maintain heat or didn’t winterize their plumbing, they would have no freezing (and resulting water damage) coverage. Even if the prior homeowner had insurance, their insurance protects their insurable interest in their home. They no longer own the home, and they no longer have an insurable interest. If they had insurance, their insurance has absolutely no obligation or duty to you.

    Your short purchase was very likely done with “as is” provisions in the contract so whatever condition the home is in at closing is what it is.

  1980. May 25th, 2015 at 1:52 pm #Luis

    Thanks for the fast reply Jason. There was forced place insurance on the property that the bank automatically put in. I started a claim last week with a hope and prayer that there was a chance I would be able to go after the previous homeowners insurance. I knew it was unlikely but It doesn’t hurt to try. And also the reason why I tried was because I was informed by another investor years ago who had a similar situation. He purchased a property that had an underground storage tank. After he purchased it he went to remove the tabk and found there was a hole in the tank and there was spillage into the soil which went downhill so it contaminated a large area. It was over $150k worth of damage and he went after the previous homeowners and he was able to get half of the money for the damage. I don’t know how or why maybe he fought it really hard with his attorneys I’m not sure but have u ever dealt with a similar situation before? And do u think I should use an attorney or public adjuster to help my cause? Thanks for any help in this matter

  1981. May 25th, 2015 at 5:19 pm #Jason

    Luis,
    That mortgage holder’s forced insurance benefits only the financial institution, and that insurance has nothing to do with the prior owner. The prior owner is no longer in the picture since you are now the owner. The financial institution and their forced insurance company have no obligation or duty to you.

    The situation you described as similar is not similar at all. Pollution coverage in a homeowner policy, for the most part, is entirely excluded. I don’t know the details of the situation you described but it may have had something to do with owner liability relating to an EPA pollution site in which liability remains with an owner, and all subsequent owners, of a polluted property until the pollution is entirely cleaned and the land is declared as no longer polluted. Frankly I don’t care because that is not the issue I’m addressing.

    As I’ve indicated before, I’m fairly certain you purchased the property “as is”. With an attorney, you would need to have a party at which to direct your claim and there is nobody left since the financial institution, their forced insurance company, and the prior owner are out. The most responsible party at this time is you.

    With a public adjuster, he needs to have insurance coverage for him to assist you. There is no insurance for an event which clearly happened before your supposed property insurance started in April.

  1982. May 27th, 2015 at 10:45 am #Tony

    We live in a Levitt Levittowner in Levittown, PA (original) and we have a car port where the roof line extends off the original house and is supported by three pillars of cinder block; the top block is cut so that the roof line sits in the block and the roof is pitched downward. Over time due to some harsh winters, the cinder blocks started to crack and now 2 of the 3 pillars now have a crack thru the center and is on both sides of the blocks. This structure was present when we purchased the house. Could this be claimed under our homeowner’s insurance?

    Also, the concrete on our patio by our front door had an existing crack, but over time the crack spread clear across the width of the patio. In doing so, the patio started to slide downward and is noticeable by the small line by the horizontal cinder block that delineates the car port and the patio. Could this also be claimed under our homeowner’s insurance?

  1983. May 27th, 2015 at 6:26 pm #Jason

    Tony,
    You can make a claim for anything you want. Your insurance covers damage that occurs both suddenly and accidentally. Neither item you mentioned sounds like it occurred suddenly.

    Your policy excludes things such as cracks in floors, walls, and ceilings. Your policy also excludes wear and tear. The things you mentioned sounds like general maintenance items that need to be done every once in awhile. Oh, your policy also excludes general maintenance. If you made a claim for the items you mentioned, your claims would very likely be denied.

  1984. June 6th, 2015 at 5:07 am #Andy Moler

    Is suicide a covered loss using explosion as the cause of loss.

    Can you make the argument that the suicide was intentional but the ensuing damage was not?

  1985. June 6th, 2015 at 9:15 am #Jason

    Andy,
    A homeowner policy provides specific coverage to personal property for explosion. Explosion causing water damage is also explicitly covered. Earth movement or trees-shrubs-other plant damage caused by explosion is also covered.

    A cause of loss, not specifically excluded, like explosion, appears to be a covered cause of loss. I indicate appears to be a covered cause of loss because the intentional loss exclusion includes the “with an intent to cause a loss”. The act of suicide is not usually done with intent to cause a loss to property.

  1986. June 12th, 2015 at 8:59 am #Mark Monroe

    Can an ins co refuse to renew your policy after a 70K claim and use the excuse of poor management because the damage was caused by the police shooting the place up with tear gas to get my 31 year old son out of the home due to drugs. Now it is being extremely hard to get insurance.

  1987. June 13th, 2015 at 8:57 am #Jason

    Mark,
    Yep, your insurance can non-renew you for any reason they want. In fact, they don’t even need a reason. However, a 31 year old drug kid is probably a really good reason not to insure you. You probably need to get your household in order before you can find reasonable insurance again.

  1988. June 15th, 2015 at 10:56 am #Dan Smith

    Would like to know if I can challenge a claim that was denied by State Farm. Plumber found a cracked sewer tile near the foundation of our house. In the opinion of our plumbing contractor, the broken sewer tile was caused by a footing that had settled over time. To make the fix, we had to remove a slab of concrete and retaining wall. There was no damage to the interior of our home. The claim was denied. Do I have an argument?

  1989. June 15th, 2015 at 1:33 pm #Mark Monroe

    Jason…That “31 year old drug kid” is a PERSON, and he is also my SON. I have my house in order. You ought to get more facts before you make ignorant comments such as this.

  1990. June 16th, 2015 at 6:03 am #Penny

    I had renter’s insurance and recently went through a house fire 9 months ago. Inurance paid contents claim and placed us in temporary housing for 6 months. Arrangement were made through an outside agency. Temporary housing ended Feb. 2015. Insurance has since closed claim and dropped me for renter’s insurance. Now outside agency is billing me for deposit on temporary housing that was paid upfront to landlord. Landlord has not paid it back. Can they bill me or should they bill insurance?

  1991. June 16th, 2015 at 2:05 pm #Brittany

    We had a Storm come through about a month and a half ago. We filed an insurance claim with our insurance (USAA) for some things that were damaged. Our dog kennel was one of the items we put on the claim. We were able to salvage the kennel itself but not the roof for it. The adjuster came out and took pictures of everything however we haven’t heard from USAA to see what they are covering. Sunday we came home to discover our neighbors tree had fallen, it fell into our yard. It smashed our fence and demolished our kennel, it is now unfixable. Can we make a 2nd claim for our kennel on our neighbors insurance?

  1992. June 17th, 2015 at 7:06 pm #Jason

    Penny,
    They can bill you since a security deposit is your expense. It’s for damage done to the place and that it not something paid by insurance. Deposits should be returned if there is no damage to the place you lived in.

    Perhaps you should ask your questions to your insurance adjuster.

  1993. June 17th, 2015 at 7:10 pm #Jason

    Brittany,
    Don’t waste your time filing a claim with your neighbor’s insurance company. Your claim will be denied because your neighbor doesn’t insure your property. The tree that fell on your property has no bearing based on whose yard it came from. Your insurance company insures your property for acts of nature and that is exactly what happened. Even the tree debris removal from your yard is all on you.

    If you have damage to your property, make a claim with your insurance company.

  1994. June 17th, 2015 at 8:23 pm #Jason

    Mark,
    Please forgive me. I should have said 31 year old drug-son who precipitated 70k worth of damage to your home. I am fully aware your drug-son is a person. Your house is not in order if you allow a 31 year old son to cause such havoc in your life and your household. Please note that when police are lobbing tear-gas canisters into your house, something is amiss. My comments were based on the information you provided in your post.

  1995. June 17th, 2015 at 8:31 pm #Jason

    Dan,
    Home owner insurance covers sudden and accidental damage that is not otherwise excluded. You describe the damage to the tile as “caused by a footing that had settled over time”. The “over time” is not sudden. Also, settling is specifically an excluded cause in your policy.

    It seems the opinion of your plumbing contractor that he supports the corrective actions he needed to do is not covered damage. I believe the denial was correct.

  1996. June 18th, 2015 at 6:19 am #Mark Monroe

    Jason. My Son is not a “drug Son”. He is a Young Man, A PERSON who was struggling with issues in His life, and we were doing all we could to help Him. PEOPLE who care about one another do this sort of thing for one another, and especially for their Family. I did not “allow” Him to do this damage, and we have taken the necessary steps to prevent anything like this from ever happening again. My house is in order and you have no business whatsoever making judgmental uninformed statements about my home. I am well aware of how things are “amiss” when police lobb tear gas into a home…., I do not particularly need reminded of its horrors, and especially in such a rude manner. You seem to have much to learn about life, I.E when a true apology is given, it is not followed by more insults, and ignorant comments that merely show one’s lack of integrity.

  1997. June 21st, 2015 at 12:10 pm #Lee

    Back in February, my pipes froze, caused major damage, etc and the insurance company is covering the repairs and rental of my temporary housing. It took a long time getting local county building permits, etc, but the contractor finally started in May. He is only half way through, with at least another 2 months to go he says.

    The property has been on the market (even before the event/claim), and now I have a prospective buyer wanting to write a contract. They have asked that I slow down, or preferably stop altogether, the work. They want to have the house finished their way, not to have redundant work done.

    How does this work? Will my insurance company allow this? Will they re-assign the agreement to repair? I know the contractor will gladly make changes, as long as the changes are paid for, and the buyers are willing to pay extra for the extra work. I know insurance companies get mad when people have devastation, and decide just to sell out, not repair. But this is not my case… I was trying to sell even before the pipes froze. The work should and will be completed, but not in time for settlement. And now the prospective buyers want to add on. In otherwords, I want the work done, so does the buyer –he just wants to make changes before it’s too late.

    And how should we frame the value of this, and who pays for what? For instance, if the house is worth $500, the insurance has already paid out $50k for water mitigation and housing for me, and the contractor’s bill is going to be $75k (and the insurance company has agreed to pay the $75k). Where do we draw the line on the value of the house/what the buyer should pay/what I should receive???

    An additional wrinkle too: my house was built prior to code requirements, so now I’m on the hook for having the contractor also upgrade/change some things with the foundation, because they will now not pass inspection. Who should pay for this? Me, and try to recoup the expense in the sale price?… or the buyer in his final bill from the contractor?

    I want to proceed carefully, with what I ask or say, to both the contractor and my insurance company. I don’t want to cause any problems or have the insurance company take back their promise to fix my house.
    Thanks for your help and advice.

  1998. June 21st, 2015 at 12:31 pm #Jason

    Lee,
    Your buyers have no say in what’s going on with your repair. Only you do. So what if the buyers want other things put in? That is their preference. If you let them get involved where they don’t belong (before they close on the house), you will have more problems and frustrations than you know what to do with.

    Get the repairs finished and let the buyers know when that will be so they can arrange for a closing. What they do to the house after the closing is of no concern to you. What they try to do before closing will only be a headache for you.

    Your insurance company has the repair option for you and they owe nothing to the potential buyers.

    Oh, one more thing. If you let the buyers make all the changes they want and the changes get done, they may not buy the house and you have it completed with their choices. Don’t confuse your current situation – keep the potential buyers out of the repair process.

    As far as your foundation, insurance policies generally don’t cover foundations/footings. Talk to your claim adjuster if they can apply the code compliance allowance of your policy to the code requirements.

  1999. June 22nd, 2015 at 12:44 pm #Sean Low

    We just bought a house in Petaluma California in November 2014. We had a report that said roof was in good shape and needed minor repairs. Over the winter, two huge storms hit Northern California each with sustained winds at hurricane levels. Part of our roof came off each time. The contractor that did the patch thought we needed a new roof now. We had an independent contractor confirm. We submitted to USAA and their first adjuster sent a roofing company that also confirmed. They then sent a second adjuster 3 months later and they said the roof had minor damage and did not need to be replaced. They went back to the first adjuster and told them to revise their estimate to only cover direct damage as they would not cover replacement. Policy says that they will cover repairs to prevent future damage and ALL agree that we need a new roof. I am at a loss for what my rights are and what i should do. Wondering how this can be going on so long and how they can randomly decide to disregard what the first adjustor said and set us up for future claims when the next rainy season comes.

  2000. June 22nd, 2015 at 2:10 pm #Jason

    Sean,
    First, I have to correct something you said. Your policy does not indicate it will cover repairs to prevent future damage. Your insurance policy is a reactionary instrument, not a preventative one.

    If a roof can repaired, then it should be repaired. If the cost of repair is the same or more than replacing the roof, then it should be replaced.

    Contractors (and I don’t care if they’re independent or not) would rather replace an entire roof, than make repairs to a roof. There’s money in repairs but there is way more in the process of replacement.

    If you had to pay for the roof repair, or a full roof replacement and you had it come out of your pocket, what would you do to your damaged roof? That is what the insurance company should do for you. I don’t know the extent of your roof damage. It’s true that your policy only covers direct damage. Undamaged roofing doesn’t need to be removed and replaced if your roof can be repaired.

    USAA is a good company. If you have questions/concerns about your claim. Talk to your adjuster candidly or talk to his/her claim manager so you are comfortable with what is going on.

  2001. June 23rd, 2015 at 8:18 am #Lee

    thanks Jason for your response.
    I think you misunderstood my question though. Go back and read the second para.

    I have no intention of changing things! I understand all you said, and agree. The buyers want me to slow or even STOP work, so they can settle on the house before any more work (that they would rip out) gets done. They will do what they want, on their dime, of course, as it’ll be after they close.

    My question is how to handle USAA, the insurance company? what to say that won’t piss them off? I don’t want to lose them as my insurance company, or have them possibly make me pay them back for the $50k they’ve already paid out on my behalf… And how would this work (who gets paid for what and how much work?) I imagine the first thing they’d do is stop paying my temp housing, if I asked for a stop on construction work. The insurance company wants the work done asap, so they don’t have to keep paying for my rental house!

    USAA has already paid out $50k to other vendors on my claim, and has another $75k to pay the contractor to finish his work. What happens to that remaining $75k? Is USAA still obligated to pay the contractor for $75k of future work, after I no longer own the house? I don’t think they’d just give the $75k to me or even my mortgage company, so that I can in turn take $75k off what the buyers pay me for the property.

    The point is that I want to close on the house BEFORE the work is completed, because
    1) it still will take another 2-3 months for the work to be done and I need to sell NOW
    2) I don’t want to lose this buyer as I have been on the market for a long time!
    3) the buyer wants to make changes

    — so How I do I brooch this with USAA???

    Thanks

  2002. June 23rd, 2015 at 9:27 am #Sean Low

    Hi Jason:

    I hear you and I truly want to do what is right for the house. I am not a roofer and i want to rely on what their expertise tells me to do. If I had to pay out of my pocket, i would listen to what they had to say. Fact is though, it is their vendor saying that we need a new roof. Of course roofers want a bigger job, why i really did want USAA to send their guys, which they did. It is just that they have been trying ever since receiving that recommendation to say that that report is not accurate. I have been in contact with USAA alot and they are a good company but it is frustrating to not know who to trust. Now they are sending an indepenent engineer to determine what is storm and what is wear and tear. Guessing our report that we received when we bought the house in November does not count for much?

  2003. June 23rd, 2015 at 12:52 pm #Sean Low

    And Jason, I just double checked my policy says that USAA will “take all necessary measures to protect against further damage”. Not sure how to interpret that as preventative. If the roof is compromised as the result of a storm and replacing it is the best way to protect against further damage, why would that not be the way to interpret the policy?

  2004. June 23rd, 2015 at 6:40 pm #Amy

    We recently had a slab leak. We received all but the funds for the desperation amount of the claim. The work has been done and paid for but the repairs ended up costing less than the claim. My question is are we still entitled to the desperation even though the repairs ended up costing less than the claim?

  2005. June 25th, 2015 at 11:47 am #Moe

    Jason,

    First let me just say WOW! This information really gives the everyday man a hope for fairness. I’m new here but my family is in the midst/beginning of a situation that we could use your expertise on.

    We were getting sick, rashes, sinuses, headaches, memory loss and recently, numbness in my body. We looked up some stuff on Google and did discover the issue. We called out an inspector who found mold in the basement and high levels of it. We’re renters. The AC wasn’t working, which we requested be replaced before moving in 7months ago in the winter time. They sent an estimator out who said the mold was a problem and the cause was a faulty/leaky door in the basement, the AC AND, water intrusion through rotting wood in the foundation near the back deck, chimney and basement. All of this has led to mold growth on items in my workplace (work from home) and the side effects.

    We’re set to see a toxicologist in a week (waiting list) to make sure that we’re okay. I have an 8month pregnant wife, a 2 year old and a boxer.

    I’ve called the property management company to ask for assistance with the doctor bill that’s coming. They haven’t given it up, but they are trying to send someone out to remediate the home.

    I can’t work because I can’t be in the basement anymore and have to take all equipment/work office and all upstairs. I have to cancel all students from coming over. How should we go about getting help from them for the loss of moldy stuff in the basement and the medical stuff? Should we seek an attorney?

    Thank you VERY much if you’re able to answer this.

  2006. June 25th, 2015 at 6:42 pm #Jason

    Moe,
    There is mold everywhere. Mold is either is at very low levels or sometimes very high levels – or at levels inbetween. Your landlord isn’t responsible for low or high levels of mold you encounter. It doesn’t matter if it’s in the home you rent from him. He is not responsible for your health and your exposure level to anything, including mold.

    You will have little to no success in your landlord paying any medical bills of yours.

    If you don’t believe you can safely live in the home, let alone work in the home, the only remedy you have is to move.

    Your renters insurance doesn’t cover mold. Your landlords insurance, and your landlord, is not responsible to you for any mold on any of your property. Lastly, don’t waste your time, the attorney’s time, or your landlord’s time by talking to an attorney. Your landlord is not liable to you for anything.

  2007. June 25th, 2015 at 7:11 pm #Jason

    Lee,
    You don’t have a buyer, you have a prospective buyer. I didn’t misunderstand anything.

    1. No, you don’t need to sell now. You can get a contract and close on it later. Selling isn’t a do or die event.

    2. This is 1 buyer. There are millions of other buyers out there. If you lose this one, there will be another.

    3. If the buyer wants to make changes to your existing house, he doesn’t want your house as badly as they and you think they do.

    If you want to chase these potential buyers, you can. That is entirely up to you. When all is said and done, and they convince you to make all the changes to your home without a contract and serious escrow money, they are not serious buyers.

    As far as what you can do with USAA, is that you need to talk to them. They are a great insurance company and let them know your thoughts and ideas. Ask them what you can and can’t do with your claim. You need to ask them directly because I am not involved with your claim.

  2008. June 25th, 2015 at 7:21 pm #Jason

    Sean,
    You don’t need to be a roofer to understand minor, moderate, and severe damage to a roof. It’s common sense.

    If you have to pay out of pocket, you would listen to who – the contractor who said to repair it or the contractor who said to replace it? I don’t think you provided an honest answer.

    I don’t care who the roofer is, who the vendor is, who the insurance company is, if your roof is repairable, it’s repairable. If I have to go on my past experience and knowledge, I go with USAA’s decision that the roof is repairable and the initial scope of damage that included a roof replacement was incorrect. Again, I say this because I know USAA is a good insurance company and I trust the company as a whole.

    An engineer will likely confirm the repair decision and if that is the case, that reinforces what should happen to your roof.

    Your pre-purchase report is meaningless to your current claim(s).

  2009. June 25th, 2015 at 7:32 pm #Jason

    Sean,
    Regarding, “take all necessary measures to protect against further damage”, that pertains to you. You must take all necessary measures to protect your property against further damage (after a loss).

    Here is the specific language that indicates it is you who must protect against further damage: (The wording in your specific policy may vary slightly.)
    B. Duties After Loss
    In case of a loss to covered property, we have no duty to provide coverage under this policy if the failure to comply with the following duties is prejudicial to us. These duties must be performed either by you, an “insured” seeking coverage, or a representative of either:
    4. Protect the property from further damage. If repairs to the property are required, you must:
    a. Make reasonable and necessary repairs to protect the property;

    You are the only one that can control further damage. The insurance company has no control over further damage. They pay for damage, they don’t control or prevent it. I cannot stress enough that insurance is a reactionary tool, and has absolutely no element of prevention at all.

  2010. June 25th, 2015 at 7:37 pm #Jason

    Amy,
    Just for an example, let’s say your insurance company estimated the cost of your damage to be $2000. They paid you $1000 and said there is $1000 more if needed. It cost you $800 to make all the repairs.

    In the above example, there was and additional $1000 available if needed for the repairs. Since the repairs were completed for less than the initial payment, there is no additional need, and the $1000 is not only no longer available, it’s also no longer needed.

  2011. June 25th, 2015 at 8:05 pm #Lee

    hi Jason,

    wow, I didn’t expect the lecture, nor want to get into an argument… I was just asking for advice how to deal with the insurance company, NOT the buyers.
    I do appreciate your responding though, and your vote of confidence in USAA.

    However, that said, you do not know my situation, so please don’t try to tell me about how to sell my house. I only am asking for insurance advice. Do NOT presume to be an expert in selling my property. I was a successful Realtor for 15 yrs.

    1) yes I DO have to sell asap, we are in foreclosure because this is an estate that was tied up for 7 yrs in legal battles by greedy beneficiaries. this IS do or die. I am the Trustee.
    2) I won’t let this buyer get away, as this property has been on the market for 2 yrs. there are NOT millions of other buyers out there for a property like this, and I am the proof. I only need one buyer as the saying goes, and this guy has finally come along. I will work with him til we close the deal.
    3) again, I have no intention of making ANY changes prior to settlement, so there won’t be any escrow issues, or me left holding the bag, or being out a lot of money
    4) they do want the house, and love it. As expected, they made a good offer today, which I am working on negotiating this very insurance issue with them, through my listing agent of course.
    5) Just because they want to make changes doesn’t mean they don’t want to buy. Again, you don’t know my situation, and you shouldn’t be presuming things or telling me about selling real estate. Stick with insurance please! FYI It is a large property with acreage, with a large manor house. The house that had the pipes freeze is a small caretaker’s home/guest house on the property, a mere fraction of the value of the property, that the buyer wants to turn into an artist’s studio with high ceilings, more windows, etc. It is only a bonus for the buyers basically, they want the main house to live in. So I’m willing to be flexible and negotiate this smaller issue in order to close the sale.

    I wasn’t looking for selling advice– only for insurance advice, how to approach USAA to get them to allow me to stop the work, yet still get the claim fully covered up to the stopping point, or possibly with a credit for the remainder of the covered work. Usaa is not insuring ME, they are insuring the property, and actually have been for 30 years, so it bears worth trying to work with USAA to keep the incoming buyers also happy.

    Thanks for your help, Lee

  2012. July 7th, 2015 at 6:20 am #Rizzie

    I currently have an open claim with USAA due to some flooding in my basement–cause was a leaky pipe. They have been great in fixing the issue. This happened in November/December of 2014. I awake this morning (7/7/15) to find that a leaky toilet has caused water to drop from my upstairs to my main level. Damaging the ceiling and running onto my wood floor–not sure of the extent of that damage. My question is should I involve my insurance company in this given that I’m still repairing the basement?

  2013. July 7th, 2015 at 6:34 am #Kathy

    Post winter this year, we noted a shift in a portion of our back porch. There was major ground freeze and heaving from the cold temperatures, and we filed a claim with our insurance carrier. An adjuster inspected and the insurance carrier sent an engineer (of their choosing) to inspect as well. The result was a denial due to a section of our homeowner’s policy that refers to pool coverage, based on an empty hot tub that sits on the foundation of that section of the enclosed porch area. There has been no water in the hot tub for 5 years. The doors surrounding the porch are off kilter and the ceiling has cracks. I find this determination to be unacceptable, as the hot tub is not a pool and is empty. We are at a loss as to how to proceed to result in our insurance carrier covering the repair to the porch so that it does not begin to collapse with another winter such as the one we just had in 2014/2015.

  2014. July 7th, 2015 at 9:27 am #Jason

    Rizzie,
    Making a claim is a personal decision. I don’t see why you wouldn’t make a claim for the upstairs water damage.

  2015. July 7th, 2015 at 10:12 am #Jason

    Kathy,
    Regardless of your hot tub, I fail to see how a shift in your back porch would be a covered event by your homeowner policy.

    Although the following policy language may differ slightly from your specific policy language, most policies cover the same things, while also excluding the same things.

    The shifting in your back porch is most similar to collapse. Collapse is the sudden falling down of a portion of your home. The shifting you indicated is not considered collapse.

    Additionally, the ceiling cracks (and out-of-plumb doors) will be specifically excluded in your policy. Insurance policies don’t provide action to prevent any part of a building from collapsing.

    ***relevant policy language***

    7) Collapse Or Impairment — “We” do not pay for loss involving:
    a) collapse; or
    b) impairment of structural integrity, including but not limited to sagging, bowing, bending, leaning, or inadequacy of load bearing capacity;

    b. In this Incidental Property Coverage:
    1) collapse of a building or a part of a building means an abrupt caving in, falling in, falling down, or giving way of the building or the part of the building that prevents the building or the part of the building from being occupied for the purpose for which it was intended just before caving in, falling in, falling down, or giving way; and
    2) the following are not considered to be in a state of collapse:
    a) a building or a part of a building that has not caved in, fallen in, fallen down, or given way even if it displays evidence of bending, bowing, bulging, cracking, expansion, inadequate load bearing capacity, leaning, sagging, settling, or shrinkage;

    8) Settling, Cracking, Shrinking, Bulging, Or Expanding — “We” do not pay for loss caused by the settling, cracking, shrinking, bulging, or expanding of:

    a) bulkheads;
    b) ceilings;
    c) floors;
    d) footings;
    e) foundations;
    f) patios;
    g) paved areas;
    h) roofs; or
    i) walls.

  2016. July 7th, 2015 at 10:34 am #Jason

    The emoji doesn’t belong in the previous post. Instead it should be an ” 8) “.

  2017. July 7th, 2015 at 10:36 am #Jason

    It should be an Eight).

  2018. July 14th, 2015 at 2:25 am #Stephanie

    My mortgage company was previously paying my homeowners insurance (forced policy) due to forclosure. The mortgage company paid through June 17th, 2015. On June 18th the policy then renewed in my name since the house had been purchased at auction and paid off. State Farm called me at the end of June to make me aware that we needed to change the bill over to me and set up payment arrangements which we did. I told them I needed to add on jewelry (wedding ring) to my policy and they said to get them the appraisal (which I already had) and no problem. When I add on the personal property rider will that start as of June 18th as well since I’m still within the 30 days of the policy renewing? The reason I’m asking is because my ring then got stolen on June 20th when my house got broken into. I was not able to get the appraisal to my insurance company sooner due to being out of town and now they are giving me different answers and the run around. I had assumed, like car insurance, you had 30 days to add on to a policy.

  2019. July 14th, 2015 at 3:29 am #Jason

    Stephanie,
    Don’t assume anything is the same with insurance. You don’t have any time to add to a policy. At the time you wrote your post, I don’t think your ring was insured since you indicate you will add it at some future date.

  2020. July 14th, 2015 at 5:07 am #fm conte

    Stephanie,
    Most Homeowners policies have an unscheduled jewelry sub limit available, so you may have some coverage under the homeowners portion. Ask your agent to help you or read trhe contract yourself.

    FM CONTE

  2021. July 14th, 2015 at 5:13 am #fm conte

    Stephanie,

    Most Homeowners contracts have an unscheduled Jewelry sublimit available that would respond to this claim. Read your contract and ask your agent for help.

    FM CONTE

  2022. July 16th, 2015 at 7:38 am #Freyer, J

    Hello, It is now mid-2015 our home was burgled in Jan 2009. I don’t know if we may have an statute of limitations we had crossed. We lived in the Oakland Hills in Northern California. Our insurer was Travelers Group. While the police investigated the broken glass doors and they saw photographs of the jewelry that was stolen from our home, just the diamonds alone were over $100,000, not to mention various computers, a couple of gold biscuits, etc. We had accumulated all that in the home because my wife was going to travel to India in a couple of weeks and after the Christmas Holiday season, she was going to travel to India to modify and polish some of her jewelry, hence all these items in the house. Anyhow, our home was burgled and precious jewels and items amounting to about $200,000 were stolen. Our insurance paid out only $19,000. It still bothers me that they got away with so little. We wrote to Steve Westly, the then State AG but of course we didn’t hear back from him. Is there any recourse we have at this late date to revisit this incident and get Travelers to pay us a little more amount? Please let us know.
    Thank you

  2023. July 16th, 2015 at 2:20 pm #Mark

    What is the Georgia code article that states who would be named on a real property insurance claim disbursement?

  2024. July 17th, 2015 at 7:05 pm #Jason

    Freyer,
    It seems like you policy paid the limits you had within your policy. If you have $200,000 worth of property that you want insured, you will need to make arrangements with you agent to get those items insured.

    Most homeowner policies have a limited amount available for jewelry, bullion, and precious metals unless you include additional coverage and pay the appropriate premium.

    The statute of limitations in CA is between 4-6 years but since your claim was settled already and all the available coverage was paid, that doesn’t matter.

  2025. July 17th, 2015 at 7:14 pm #Jason

    Mark,
    There is probably no code to which you refer. An insurance company will pay the named insured. If there is a liability claim, the insurance company will pay the claimant.

  2026. July 30th, 2015 at 1:47 pm #chris

    Jason,

    Back in April of 2015 we got hit with a severe storm, hail, wind, lightning etc. It caused damage to our roof and of course those surround us, which all had different insurance company and got their roofs replaced. We were told it was foot traffic by the adjustor, and at that point we knew we would have to send out another adjustor, so we hired a public adjustor, we never saw a second person come out and it went straight to a arbitraitor , which told us again it was foot traffic. I can see the roof not being repaired if others in the surrounding our house or even across the street (which got a new roof) but they all had hail damage. At this point too we are fighting them as well because there was some sort of electrical surge outside during that storm either lightning or something else struck near by and took out air conditioner and hot tub, being that this happened in April and its the end of July we had to get a new air conditioning unit as we have young kids in the house and its been hot. We submitted all the receipts and letters from the air conditioner repair man and hot tub and it was still not good enough for them, they now want to sent out a electricion to come into our home and look at our wiring. We have had the air conditioner and hot tub over 6 years with no problems now they are claiming it was wired wrong. We are refusing to allow them in our home, knowing and reading on line that if they find one thing out of place its will not be approved at all, and its very well feels intrusive if you ask me.

    Anything we can do about this. We are looking into filing a claim with the insurance commission regarding the roof as I do believe it should be replaced, we had three different roofers come out and tell us we need a new roof, yet there adjustor and the arbitraitor they sent out (who they paid for are saying the same thing ) its “foot traffic” like we are having parties on our roof. The person down the street from us, has the same insurance company and was told it was foot traffic as well. I am also ware that there are others with the same insurance company, that are having issues as well.

    Anything we can do to get this taken care of? And what do they look for when they come into the home messing with our wiring?

    Thank you!

    Chris

  2027. August 1st, 2015 at 7:30 am #Jason

    Chris,
    I don’t care about any houses around your house. The insurance company doesn’t care about those houses around you either. Do you know why? It’s because they have no interest in houses they don’t insure. They have a contractual obligation to you (and none of the homeowner’s near you) to cover your property when a covered cause of loss occurs to your home – such as hail.

    I’m certain foot traffic damage is not a covered cause of loss. If there is foot traffic damage on certain areas of your roof, that may be human damage but that isn’t hail damage – even if it vaguely might look like hail damage. I’m also most certain that your your insurance company’s denial letter of your roof did not include the insinuation that you were having parties on your roof.

    The insurance company will need to inspect the damaged property (A/C unit) and since you replaced it, that may not be possible. You said you replaced it because it was hot and you have young kids. That’s not a reason to replace your A/C before the insurance can investigate your claim. Young kids don’t need A/C and that is confirmed because people didn’t commonly have A/C in their homes until the 1950s and after.

    Don’t waste your time writing anything to the insurance commissioner of your state. They don’t care about you or your insurance problems. Their single mission is to make sure the insurance industry is healthy and succeeds so they can continue having a secure bureaucratic job.

    If you refuse to let the insurance company inspect your wiring (or the damaged property), then you are refusing to cooperate in the investigation of your claim and your claim (or parts of it) will be denied. The language in your policy – to which you already agreed – allows your insurance company to inspect nearly anything it wants as it relates to a claim. When someone comes into your home, they will not be messing with your wiring – they will instead be inspecting it. It’s very likely lightning is a covered cause of loss but a power surge is not. These 2 causes of loss are distinctly different and that is what needs to be inspected.

  2028. August 4th, 2015 at 7:38 pm #diana

    my home was destroyed in a fire insurance company has said repeatedly that it is a total loss..we are insured for 391,000 on home alone but adjuster says they will only pay 170,000 for repairs we feel home is not safe as this is at least second fire we learned of a previous one 15 years ago but adjuster says if we don’t repair we only get 159,000 to replace.

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  2030. August 5th, 2015 at 6:11 pm #Jason

    diana,
    Prior incidents of damage have nothing to do with your current fire claim.
    If the home is a total loss, I don’t understand why they would be paying you for “$170,000 for REPAIRS. Is this what you meant? A home cannot be both repairable and a total loss.

    There are generally 2 parts of a claim and that is the ACV payment and the recoverable depreciation that is an amount you can claim after the repair or replacement of the damaged property.

  2031. August 9th, 2015 at 3:11 pm #Tonya

    Jason,
    I was dropping off a book at a friend’s house and slipped on his steps and injured myself. My friend turned it in to his Homeowners (Allstate) and I have a claim #. With that # what medical treatment am I allowed to seek? Does the claim # mean they will pay for it?

  2032. August 9th, 2015 at 4:46 pm #Jason

    Tonya,
    There are 2 coverages available for a homeowner, if selected, for your injury.

    The first is something that responds to your medical care an injury that happens on your friend’s property. That would be medical coverage and the amount available for your medical treatment, if he/she selected this coverage can be $1000, $5000, or maybe more (but probably not). This coverage does not require the property owner to be negligent.

    The next coverage is his/her liability coverage that covers for his/her negligence. For example, if the steps were in disrepair or severely uneven. Any visitor to his/her property needs to take care in their use of those steps. Since you didn’t mention a fault within the steps or negligence that your neighbor did or didn’t do that cause your injury, this coverage probably doesn’t apply.

    If you have a claim number, they have acknowledged your claim and they may pay for your related medical expenses. Regardless of who pays for it, if you need medical care, you need to get that medical care.

  2033. August 10th, 2015 at 3:56 am #Tonya

    Thanks Jason
    He wasn’t negligent. It just worries me that the claims person was rude and in my opinion was insinuating fraud with statements like “No one saw you fall” and “You didn’t go to the ER”. I am not a rush to the Dr. kind of person and gave it weeks to heal on it’s own. Once I realized it was more than I thought only then did I ask my friend to contact his homeowners.

  2034. August 10th, 2015 at 5:59 pm #Jason

    Tonya,
    No one needs to see you fall in order for you to have fallen. If you don’t have medical bills for the claim adjuster to consider, send them a letter detailing your injury or injuries, the length of time for recovery, and what medical care you took to arrive where you are today.

  2035. August 11th, 2015 at 3:12 pm #Shana

    Have FULL replacement cost insurance on mobile home as well as flood – Our area was recently (county wide) filed as a “Catastrophic” area – due to torrential rainfall (lake across hwy rose over 13 FT)- long story short- our m/home is on the bottom of a hill – (in a subdivision) – the recent rain (on top of the rain washing down the hill) has compromised our foundation as our house is sliding backwards- (making roof sag, main bean buldge, floors/doors uneven and the list goes on…) – Our adjuster claims it’s soil issue and is not covered since NO actual flood waters came into the house?? Do we have any legal recourse?? We are talking $50,000+ in repairs-

  2036. August 13th, 2015 at 5:16 am #AMY

    I’m in the midst of a claim for ice dam damage, been fighting with insurance co for months on a supplement to the claim – which delayed reconstruction because items on supplement affected construction start. Now I went by the house to check on something and found that much of my copper pipe in the basement was cut out and stolen. Contractor is going to get his plumber in to completely evalute the situation and get a cost together on repairs of this but, If i now file a claim on the vandalism/theft how likely is it that they will a) deny the claim, based on house not being completely secured b) cancel my policy for filing another claim ? What if anything can i do here?

  2037. August 13th, 2015 at 5:17 am #AMY

    I’m in the midst of a claim for ice dam damage, been fighting with insurance co for months on a supplement to the claim – which delayed reconstruction because items on supplement affected construction start. Now I went by the house to check on something and found that much of my copper pipe in the basement was cut out and stolen. Contractor is going to get his plumber in to completely evaluate the situation and get a cost together on repairs of this but, If i now file a claim on the vandalism/theft how likely is it that they will a) deny the claim, based on house not being completely secured b) cancel my policy for filing another claim ? What if anything can i do here?

  2038. August 15th, 2015 at 5:19 am #Jason

    Amy,
    An insurance contract is a voluntary agreement entered into by 2 parties for each party’s mutual benefit. You get insurance coverage, the insurance company makes money. If the agreement is no longer beneficial for either one, it can be terminated. When the benefit to the insurance company is no longer there, they may cancel a policy.

    No property is every completely secured so that probably will have no affect on your claim. People file claims all the time. If you have a legitimate claim, you should file it.

  2039. August 24th, 2015 at 1:23 pm #damien

    thanks for your help. i have a large tree close to my house in back yard. the roots are lifting and cracking the back patio slab, now tilting towards house. rainwater rushes now to the house. buckles the floor inside (pergo type ) and floods my garage now has rotten sheetrock and mold.
    can i make a claim?

  2040. August 24th, 2015 at 1:31 pm #damien

    thanks for your help.
    i have a large tree close to the back of my house ,which has roots pushing up and cracking my rear patio slab, which now tilts towards the house and pushes rainwater to the house..the (pergo type) floor is now all buckled, and my garage keeps flooding and now has rotten sheetrock ,rotten wood and mold. i have tried to stop , trench etc..but not much result.can i make an insurance claim ?

  2041. August 24th, 2015 at 1:34 pm #damien

    continued..therefore i need to demo the slab(and rebuild), build a drain system,
    redo my house flooring, and garage misc carpentry..

  2042. August 24th, 2015 at 5:05 pm #Jason

    damien,
    If you have rainwater rushing into your house, you need to correct that situation so the water doesn’t enter your house. Your insurance covers things that are both sudden and accidental. The growing tree roots were not sudden, the lifting of the patio slab was not sudden, and the rainwater which entered your house was not sudden (since the roots and slab happened over time). Sure, the other element of accidental may be there (but maybe not) but both elements are needed for a covered claim for which a covered cause of loss occurs. Roots, patio slab orientation, and water rushing into your home at or below ground level are not things covered by your policy.

    Can you make a claim? Sure, you can make a claim for anything you want. If you do – prepare for a thoroughly written denial letter.

    The work and repairs you need to do falls under the category of homeowner maintenance.

  2043. August 29th, 2015 at 12:29 pm #gr

    I had a house fire, all my wifes jewelry was covered in soot. Went to several jewelry stores to get the jewelry cleaned. None wanted to do it because it was to dirty. We did get a estimate from a jeweler whos has been in business 40years. The estimate he gave was fifteen dollars per piece.Since we cannot find someone to clean it. Can we do it ourselves and turn the estimate in and get paid.

    Thanks
    GR

  2044. August 29th, 2015 at 3:06 pm #Jason

    gr,
    That is a question you should ask your insurance adjuster.

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  2046. September 2nd, 2015 at 5:57 pm #Ernie

    I just bought a bi-level house that had been vacant for two years. The house has a new roof along with new kitchen, carpet and paint throughout. 10 days after settlement, I went on a vacation and when I came home the bottom level, which has open doors to the outside were soaked with water. Further Inspection revealed that during a bad rainstorm while I was away, my main rain gutter pulled away from the house causing water to cascade down the front of the building. My heater vent on the roof also failed causing water to come straight down the vent soaking the utility room. I cleaned up as much water as I could and then had a friend re anchor the gutters and seal the vent pipe where the water had come in. About 10 days later though, I noticed mold growing on the interior walls and decided i may have more damage than I thought, so I filed a claim.

    The adjuster denied my claim because even though the gutters failed, they felt that the water that came in the house was groundwater which was not covered. When I asked about the water that came through the vent, he said that while that was true, prior incidents of water could be seen.

    Should I appeal? I can’t believe a leak caused by a failure in the roof would not be covered. I also don’t think I should be held accountable because of previous issues which were fixed.

  2047. September 2nd, 2015 at 10:42 pm #Jason

    Ernie,
    Your insurance company provides coverage for accidental and sudden damage for things that are covered in your policy. Water which enters the dwelling at or below ground level is excluded. So let’s focus on the repeated water that entered through the vent.

    Your policy covers for accidental and sudden damage. The damage you experienced with the water through the roof was accidental and repeated. There is nothing sudden about that water entry if it entered at previous other times. There are also exclusions in your policy for improper maintenance and/or construction so if water is entering where it should not, that is not and insurance company issue, but rather an ownership maintenance concern.

  2048. September 7th, 2015 at 11:25 pm #Catherine

    I have been living with my boyfriend (the homeowner and insurance carrier) for about 6 yrs at about the end of April 2015 our house caught fire and was a total loss. I’ll try and make this as short as possible i had moved into the guest room of our house with our 2 yr old son i had fallen asleep around 2:30am and not long after vaugley heard what i thought was someone say fire, i don’t think i responded right away but shortly after i began to hear my 2 other daughters awake and panicked i awoke to see absolutely blankness i tryed to feel for my son and i guess i grabbed him and ran to the hall my daughter’s were there saying get out the house is on fire confused as now outside my room there was no sign of anything or my boyfriend we ran outside long story short my boyfriend claimed he had no idea what was on fire i looked found about a 4 inch flame on a table on our back porch slammed the door and went to tell my bf i had found it it was nothing to go get the fire extinguishers from the basement could put it out he refused said hes not a fireman and for me to get the hell out of the house this whole time he had been emptying the house of his things (coats shoes picture paperwork) i left my cell in my bed as i couldn’t see anything and asked if hed called 911 he said no i was in shock i went a little crazy begged for the phone and no i had to get outside to my children it had been about 10 min so i hoped hed do the right thing he ran in and out for another 10 min by this time the Windows on the porch had exploded out and a power line was shooting sparks everywhere they came 20 min later we left to the hospital as we all suffered smoke inhalation he stayed all morning im sure to make sure it was a total loss which it was a fire det came to interview me said the fire was intentional and because 98percent of ny children and my stuff was destroyed he highly doubted it was me. My boyfriend was given a 820.00 gift card from red cross for all of us we never lnew a thing until recently we weren’t named on his policy allthough he boarded up the house and said we couldn’t touch anything until his adjusters priced it he kicked us out of the hotel the redcross payed for on the 3 day stating he didn’t have to help us hes been given over 200,000 by his insurance company purchased a 120,000 home in a beautiful neighborhood as the fire home was a 37,000 home in a terrible neighborhood he claimed all of our belongings rented a dumpster while i was going to our home trying to salvage what i could and threw it away without any warning none of this seems legal i lost everything i had actually tryed months before to get a renters ins policy but was denied because iit wasn’t a rental property he said at first hed pay 6 mnths rent and utilities buy my furniture amd replace all of our stuff then that changed to ill give you 3000.00 and now nothing do you know if i can sue or who to sue and would it only be in claims court none of this seems right he let the house burn down and then banked off all of our belongings and we have to walk with nothing? live in Rochester ny and i appreciate your time thank you, Catherine

  2049. September 8th, 2015 at 3:33 am #Jason

    Catherine,
    It’s not really a rental policy. It’s a policy that covers your liability and your personal property from damage. It has nothing to do with the place in which you live – other than you can’t own it.

    If you don’t have insurance, and you had this worthless/selfish boyfriend, you have no remedy for your loss. I am unable to determine who you could sue. Not his insurance and not him.

  2050. September 8th, 2015 at 9:49 am #gerald rorabaugh

    Housefire covered all my wifes jewelry in soot, Couldn’t find any jeweler to clean it. Soot appeared to be very corrosive, My policy said I must mitigate damages, So we cleaned it ourselves to stop the corrosion. Insurance now says they wont pay because we cleaned it, It says the insured should mitigate further damages’ In our policy, Have 90hours invested in cleaning.

    Any advice on this situation
    Thanks
    GR

  2051. September 9th, 2015 at 3:39 am #Jason

    gerald,
    Soot does not appear to be very corrosive. It doesn’t have that type of appearance, it just is to certain items.

    90 hours is really over 2 full work weeks of cleaning and seems excessive. A jeweler probably could have given the entire lot of jewelry an ultrasonic bath for 30 minutes, dried the jewelry, and they would have been very thoroughly cleaned.

    Yes, you have to mitigate your damages, but your insurance pays you or reimburses you for your cost/expenses in your mitigation efforts. Please be aware that you have a sub-limit that applies to jewelry in your policy and it’s not very much.

  2052. September 9th, 2015 at 6:51 pm #Charlene

    I have water damage to the whole house from bad siding on the house. There is flooring that is rotting, water marks and drywall cracking. I can not even water the yard because if it hits the siding the GFI switch will pop on the house.

    the gutters have been put on wrong and the water is also causing black rot and water leaking. they are even starting to fall off.

    What do I have to do to get my insurance to help cover this? I have been told that the house has to almost be gutted to fix this contractor issue.

  2053. September 10th, 2015 at 3:31 am #Jason

    Charlene,
    Of the conditions you mentioned on your home, it doesn’t sound like your insurance company will address any of it.

    There is nothing you have to do or not do for coverage. If it’s covered, it will be covered. If it’s excluded, it won’t be.

  2054. September 12th, 2015 at 12:01 am #Maria

    Hello,
    Our home was destroyed in a fire 5 months ago. The insurance company has called it a “standing total.” All of our personal belongings have been lost. We were placed in a hotel for two weeks and now a rental home . The insurance claim seems to be taking long and we have hired a private adjuster. The private adjuster has been a little slow and says that we must be patient. He told us that we would get a first offer which we should not take from the insurance company. Then he waited about 3 weeks and says that we should take it. We then find out that the insurance will only cover half of the house to be knocked down and replaced. Mold has grown outrageously in half of the house as the firemen had to use foam instead of just water. We have 4 small children and are concerned about just spraying the beams they intend to keep. Not satisfied we pushed our adjuster to send back their builder. He was quite annoyed that he had to come back and tells our adjuster that the insurance company should not pay for floor joists that the “homeowner” cut into. Not sure what that has to do with mold but he claims that the integrity was compromised by the “homeowner” in regards to the floor joists. This obviously was not done since we began the policy over 10 years ago but of course that was never checked. We are looking to have the house knocked down anyway. We have now decided to go with a modular home because we are concerned with running out of time/rent allowance with the insurance company. Obviously modular is less costly than stick build and can be done quickly. Here is where it has become tricky. Our private adjuster has explained that we have a replacement cost policy. The insurance has awarded 328k but has a holdback of 80k. I am already not happy with the number but my adjuster says not to push too hard because they can take money away. Because we will go with a bigger modular home, is the insurance company able to keep the holdback because we have decided to go larger with a new home? I understand replacement cost with personal contents but if our new home will cost close to what they are allowing will the upgrades not allow for our holdback to be released? It stinks that I do not trust my private adjuster as he keeps giving me conflicted answers.

  2055. September 12th, 2015 at 8:41 am #Jason

    Maria,
    You are paying your adjuster to address your insurance concerns and to maximize your claim value. You should address all your questions to the adjuster you’ve hired.

    If you can’t trust your adjuster, hire a different one. Trust is important when you are dealing with 1/3 of a million dollars.

  2056. September 16th, 2015 at 8:20 am #gerald rorabaugh

    If my insurance cancels my policy during a claim. Do I still have to participate in subragation on their behalf,

    thanks
    gr

  2057. September 16th, 2015 at 3:49 pm #Hope

    I recently suffered some storm damage to the siding on my home & some roof damage to the garage.
    I purchased my home on a land contract with the “prior/current owners” approx 6+ years ago. They & the mortgage company (of who I was unaware that there was one until this incident) are listed on the homeowners insurance policy along w/me.
    To help with explaining the situation I should mention that I am also in a current dispute w/the “prior/current owners” on repair work that is being done to the foundation. They offered me an ‘out’ of my contract but I wanted to stay so I offered in good faith to help pay up to $10,000 towards repairs in an addendum. I agreed to sign the addendum to the 1st agreement to repay the money spent on repairs when they finish the work. It has been over 2 years & the work still hasn’t been finished, so no addendum has been signed. There was contractor negligence & more damage has been caused. They don’t want to be responsible for enforcing the repairs necessary & stopped working. They then also realized that they budgeted terribly & have decided that they don’t want to complete everything listed on the agreement. So we are arguing over them finishing what they started. They decided they were going to finish a couple of items (that weren’t finished prior to their decision) & call that good. Hence the dispute.
    So, back to the storm damage… I filed a claim & the insurance company wrote the check to the “prior/current” owners, myself & the mortgage company. The mortgage company is setting up an escrow account. No problem so far. Then the “prior/current” owners had done my land contract sale w/out the permission/knowledge of the mortgage company and because of this the mortgage company said that any insurance monies left over would be absorbed into the loan of the “prior/current” owners. The mortgage company suggested to me that I have the “prior/current” owners apply that same amount to the loan I have w/them to keep if fair. I don’t agree w/this but have no choice. So then the “prior/current” owners tried to tell me that the bank required me to sign the addendum before they would go any further. I called the mortgage company & they said that was not true & that I shouldn’t sign anything for them except what they personally ask me to. Well now the “prior/current” owners said that they won’t sign the insurance check & give it to the bank until I sign the addendum. I told them that 1 doesn’t have anything to do w/the other & that I am not signing the addendum until all of the work they agreed to do was finished. They said they will not sign the check until I sign the addendum regardless if 1 has anything to do w/the other.
    Is there anything I can do about this problem? I have already got bids for the work & am ready to get the storm damage repaired.
    Thank you.

  2058. September 16th, 2015 at 9:13 pm #Jason

    gerald,
    No, their subrogation needs should have already been met, and generally, they don’t need you to do anything anyway regarding their payout recovery attempts.

  2059. September 16th, 2015 at 9:17 pm #Jason

    Hope,
    Your issue isn’t an insurance problem – only an owner/buyer problem.

  2060. September 26th, 2015 at 9:25 am #Suzanne

    I contracted with a big box store for a new roof on a two story open loft exposed wood ceilings log cabin. The first roofer flooded my home and quickly put roofing over wet ceiling. The solid logs withstood the water but upstairs the dormer walls and insulation remained very wet. Leaking around the fireplace and porch continued. A much better second roofer was brought in a month later and redid about half of the work. Initially their insurance company said they wouldn’t replace the insulation and the cypress tongue groove stained walls. ( Interior wall is 35 years old but the insulation and the exterior walls were replaced 1 1/2 years ago.) After looking at the obvious water damage to the walls and the unidentified stuff that is growing around the ceiling beams and started along the roof ridge on my bedroom ceiling the insurance company for the store said send them an estimate.

    Should I deal directly with their insurance company? One construction company said I should talk to my Allstate Insurance company and have them deal with Sedgwick. Would it be better for me to deal directly with the insurance company for the store? Should I hire a claims adjuster? Do I need a roof inspector?

    One construction company will not even give an estimate without a mold inspection. Another company thought I had too many issues for them to handle. (Like some nails that are through my roof and are afraid of a log home.)

    I don’t want my insurance company to cancel or raise my rates. I’m trying to not make more stupid choices.

  2061. September 26th, 2015 at 7:23 pm #Jason

    Suzanne,
    Your situation is a negligent issue by your contractor. Your contractor negligently caused water damage due to their improvement work efforts.

    I fail to see how your homeowner insurance would find coverage for such an event. Sure, one construction company said to file a claim and have them work with the contractor or the contractor’s insurance but if your insurance company doesn’t find coverage, they won’t work with anybody.

    It seems you have to work directly with the store’s insurance company. If they are accepting liability, that is the first step. Next you have to have a competent contractor that makes the correct repairs to get rid of all damage so it’s like the damage event never happened.

    It’s your home. You need to decide if you need a public adjuster, a roof inspector, or a mold inspection.

    One thing you must is secure a trusted and reputable contractor. The second thing you must do is personally make sure all the damage is corrected – even if you need to hire other professionals to do that for you.

    And finally, the most important thing you should do is find an insurance company other than allstate (and/or farmers). Both these companies rank very highly in customer claim dissatisfaction. There are many, many more companies that are much better.

  2062. September 28th, 2015 at 6:23 pm #gerald rorabaugh

    who has final say weather something is salvageable, State arm says they do’ This invloves persoal property

  2063. September 28th, 2015 at 6:26 pm #gerald rorabaugh

    Who has final say weather something is salvageable, State Farm says they get final say.

  2064. September 29th, 2015 at 5:59 am #Jason

    gerald,
    Your insurance company is telling you the truth about salvage.

  2065. October 1st, 2015 at 4:35 pm #Brea

    I had and ac unit accidentally discharged water through my walls and under the floor. We did not know until we saw the floors start to buckle. We immediately stopped the water problem as soon as we saw it but there was already some mold that had grown. This is a standard HO06 10/00 form with HO 04 26 04 02 Limited fungi endorsement. The carrier is stating that coverage is limited to the endorsement since there is mold but it was hidden mold and all due to a covered cause of loss accidental discharge, does this endorsement limit still apply since it was hidden in the walls?

  2066. October 1st, 2015 at 8:22 pm #Jason

    Brea,
    Why do you ask the question based on coverage if hidden in the walls? Why do you suspect the coverage limit would not apply if the mold is hidden?

  2067. October 1st, 2015 at 10:23 pm #Brea

    Because the fungi endorsement says the following : SECTION I – PERILS INSURED AGAINST
    ​12.​Accidental Discharge Or Overflow Of Water Or Steam
    Paragraph b.(5) in Forms HO 00 02 and
    HO 00 06 (b.(4) in Form HO 00 04) is deleted and replaced by the following:
    ​(5)​To a building caused by constant or repeated seepage or leakage of water or the presence or condensation of humidity, moisture or vapor, over a period of weeks, months or years unless such seepage or leakage of water or the presence or condensation of humidity, moisture or vapor and the resulting damage is unknown to all “insureds” and is hidden within the walls or ceilings or beneath the floors or above the ceilings of a structure.

    And the policy language is this: 12.Accidental Discharge Or Overflow Of Water Or Steam
    a. This peril means accidental discharge or over- flow of water or steam from within a plumbing, heating, air conditioning or automatic fire pro- tective sprinkler system or from within a household appliance. We also pay to tear out and replace any part of a building or other structure owned solely by you which is covered under Coverage A and at the location of the “residence premises”, but only when necessary to repair the system or appliance from which the water or steam escaped. However, such tear out and replacement coverage only ap- plies to other structures if the water or steam causes actual damage to a building owned solely by you at the location of the “residence premises”.
    b. This peril does not include loss:
    (1) To or within the “residence premises”, if the building containing the “residence prem- ises” has been vacant for more than 60 consecutive days immediately before the loss. A building being constructed is not considered vacant;
    (2) To the system or appliance from which the water or steam escaped;
    (3) Caused by or resulting from freezing except as provided in Peril Insured Against 14. Freezing;
    (4) To or within the “residence premises” caused by accidental discharge or overflow which occurs away from the building where the “residence premises” is located; or
    (5) Caused by mold, fungus or wet rot unless hidden within the walls or ceilings or be- neath the floors or above the ceilings of a structure.

    Which is confusing because the way I understand it means there is full coverage if it’s hidden in the walls for this specific type of loss?

  2068. October 3rd, 2015 at 7:21 am #Jason

    Brea,
    How I read the policy is that there is coverage for 12.​Accidental Discharge Or Overflow Of Water Or Steam. The coverage then limits the coverage by: b. This peril does not include loss:
    (5) Caused by mold, fungus or wet rot…

    The limitation then gives the coverage back by using this: … unless hidden within the walls or ceilings or beneath the floors or above the ceilings of a structure.

    The endorsement seems to repeat essentially everything of your primary policy but it adds the requirement that it has to be “unknown to any insured” and places a limit on the money available for mold, fungus, or wet rot.

    When your policy is modified by an endorsement, the endorsement takes president over the primary policy in that it changes the primary policy to the conditions of the endorsement. The endorsement is clearly providing a modified coverage (lower liability) of that of the primary policy.

    With the endorsement in place, there is no longer the wording of the primary policy because it is changed to the wording of the endorsement, including the monetary limit. So, no, there is not full coverage for the loss, it is only monetary limit available from the endorsement.

  2069. October 11th, 2015 at 8:46 am #gerald rorabaugh

    State Farm had my unsalvagable items including art disposed of wothout my consent. Now instead of just picking it up and taking to a art collector. They say a picture is the same. Art dealer says picture doesnt tell the story.
    He could not give a accurate appraisal with out looking at real artwork. I never signed anything saying they could dispose of my belongings. Art was purchased in 1950. Price paid in 1950 was 15 hundred dollars. Do I have any recourse

  2070. October 11th, 2015 at 11:29 am #Jason

    gerald,
    I’m fairly confident state farm was not in possession of any of your property and it was instead a restoration company or other contractor. You don’t need to sign anything to have non-salvageable things disposed of.

    No, you have no other options.

  2071. October 13th, 2015 at 7:20 am #gerald rorabaugh

    State Farm claims I put down too many above average item, They said to change more to average or they will change all too average. I’m truthful that they were all above average

  2072. October 13th, 2015 at 8:46 am #Wanda

    I have a question, my husband was mowing someones’s yard. He ending up sliding down a wet hill on his riding lawnmower and crashed into their glass patio. He offered to pay the deductible or he said he had the glass windows to fix it. The homeowners said they had insurance they would take care of it. It has been fixed and now the insurance company is coming after my husband for 22,000! He was never asked for his side before they did work, or if had known he would have asked for more quotes. What can he do now? We have homeowners insurance ourselves but that won’t help with this.

  2073. October 13th, 2015 at 10:17 am #Liz Haluta

    My husband and I hired a contractor that the insurance company (steered us towards) because he said he could do the work for the insurance claim amount $39,000.00. We signed a simple contract for that. Now he is stating that the deprciation that we recieved from the insurance company is his as well, there is nothing in the contract that we sighned with him about that and he never mentioned that to us. Our insurance adjuster never told us that the contractor would get the depreciation money either, he told us twice that we would get that money. The contractor hired very cheap non english polish workers to complete the rebuild of our garage and we have a lot of issues and need to replace things that they broke and fixed very shotty. We also have to replace our entire patio because of the company that the contractor hired to poor the slab for the garage drove his cement trucks over our patio. How can our depreciation money from our loss just go to a contractor I was steered for without us knowing anything about it, and what legally can we do to make sure he does not get it.

  2074. October 13th, 2015 at 8:37 pm #Jason

    gerard,
    It seems your insurance company is giving you an option. Choose wisely.

  2075. October 13th, 2015 at 8:40 pm #Jason

    Wanda,
    It seems that your husband was doing something negligently that caused damage. It is legitimate that the insurance is asking that they be reimbursed for damage he caused. That’s their right of subrogation.

  2076. October 13th, 2015 at 8:42 pm #Jason

    Liz,
    Nothing. That is part of your claim and if he did the work, then he is entitled to that amount as well.

  2077. October 24th, 2015 at 12:08 pm #Jack

    @ admin

    You have made suggestions for people to blatantly mislead about claim values or how they are prepared and presented. The insurance policy is a contract for a service with certain limitations and gratuities. A homeowner has a duty that they agreed to by signing the contract which plainly states what needs to be done and presented. It’s called conditions and proving your claim. Nowhere at least as yet do I see your asking them to read their policy. You are making suggestions that usurp the wording which can be considered false and punishable as a crime and having the policy canceled and no payment made.

  2078. October 24th, 2015 at 12:24 pm #Jack

    @ Liz Haluta

    The settlement you received rom the company was explained to you and you signed certain documents that clearly indicated the the depreciation was that amount removed from the replacement cost for condition and age. You can’t expect to be paid with new for old. It’s called an “actual cash settlement” with the depreciation held until the repairs are completed. If you review your loss estimate, you’ll see that an item like say for instance, the drywall will cost the amount and due to age we deduct this amount and the net is this amount. Also know as ACV. Your contractor is correct, he is entitled to the depreciation amounts for what work he preformed. You having a problem with his quality is not the fault of anyone but yourself for not doing you’re due diligence and investigating the person you hired. He was referred to you because you asked for one. Any additional damage found or caused during the repairs are subject to the contractors own insurance. Let me ask you, did you request copy of the contractors and sub contractors insurance coverage?? Additionally, did you request to be added to the policy as an additional insured while the work was in progress?? Did you ask for and require a performance bond?? People please, most of what I read is your own fault and not an adjusters or carriers. Step looking for the freebies and free ride you’re always hearing about.

    As a matter of record, I’m not an adjuster or carrier. I’m a contractor that has to work with the likes presented here. A day never goes by that I don’t get a request to pad or asked how much can they make from a claim. No wonder insurance is through the roof.

  2079. October 25th, 2015 at 8:09 am #gerald rorabaugh

    State Farm adustor told me to inventory and dispose of 31 boxes of unsalvagable items. After they were disposed of she came back a month later and wanted them said they were state farm property. All be it I have an email from her telling me to inventory and dispose of these items.

  2080. October 26th, 2015 at 4:29 pm #Jason

    Jack,
    I’m not admin. However, you have made allegations of admin’s suggestions for people to blatantly mislead claim values or how they are prepared and presented, yet you have not referenced a single one. I don’t believe you can because that is not an accurate allegation.

  2081. October 26th, 2015 at 4:33 pm #Jason

    gerard,
    If you have the e-mail with that content, send it to her and let her know.

  2082. October 28th, 2015 at 4:33 pm #Kari

    Our house was hit by hail Last Sept. The original adjuster came out and wrote up the estimates and cut us a check for the actual cash values.

    We recently got a quote to fix our windows, gutters, and to paint our siding. The insurance company was given the quote. However, the amount the contractor is asking is more than the insurance company allotted for in the estimate, so they re-opened the claim on Oct. 5th 2015.

    They assigned an independent adjuster to our claim and he is virtually non-compliant. We have to call him all the time and as of this last week he has not done anything to rectify the claim. Every time I speak to him he makes comments of well, “I am not going to give you more money because I won’t lose my job.” Or well “typically” we don’t cover this or that. Its almost like he is fishing to find something they don’t cover so that he wont have to pay the contractor what they are asking. One day he will say we won’t pay for power washing before painting, the next its well typically we don’t pay for masking a house in order to paint. When I asked him where we were with the claim for the windows he said “no more money will be allotted, I asked why and he said “it just wont be allotted.”

    What can I do to fix this situation? Every time I call the insurance company they say I will get Mike (The insurance adjuster) on the phone and I say no, im tired of dealing with him I want a manager. They say, I will have a manager call you and no one does.

    Please help!

  2083. October 28th, 2015 at 4:47 pm #Jason

    Kari,
    Generally a home claim involving damage needs to be completed within 1 year for the total replacement cost to be paid. You were paid the ACV of the damage. The ACV paid, plus the depreciation amount, is probably close to what the contractor is charging. If the windows are more than allowed in the insurance estimate, ask if you can submit the actual window invoices (plus labor) for the window replacement allowance.

    Keep trying to reach your adjuster’s manager. If you don’t succeed with that, seek the manager’s manager. Or even the regional manager.

  2084. October 30th, 2015 at 1:33 pm #advice plz

    Hi,
    i had a house fire and have a few questions, the adjuster gives the estimate and says what the insurance will pay, do you just give the contractor the estimate and turn him loose? The acv is over $150,000 so if I did that and he comes up less than the estimate then he keeps the rest?
    If I desided to not replace a few things built in the house that i didn’t want anymore or go with lesser priced items could I use that money to upgrade other built in items instead?

  2085. October 31st, 2015 at 7:44 pm #Jason

    advice,
    You need to work out the details of the repair with your contractor. The most you should pay is your deductible.

    If you don’t want some things repaired or changes made to your home during the repair, come to terms with your contractor about that.

    Don’t ever turn a contractor loose without a complete understanding of his role and authority.

  2086. November 2nd, 2015 at 12:14 pm #Tom

    I am concerned. Can you help?

    I have a claim on hail and wind damage that was covered. A settlement Statement was prepared afterwards and I am being requested to sign to continue the process.

    The Insurance Claim had a large amount that was held or Kept as Depreciation. The settlement states Recoverable depreciation. With a note stating: ” To make claim for the recoverable depreciation for an amount in excess of actual cash value you must repair, rebuild or replace the damaged property.”

    I the Settlement agreement has an amount minus the Attorney’s fees that is calculated from the gross amount prior to the depreciation reduction.

    Can I collect the Recoverable Depreciation amount without dealing with the lawyer and his Claims Investigator? After, all the Claims Investigator and Lawyer are paid in full with the first portion received from the claim. I have had issues with the claims investigator. In addition, I want to use my own roofing company and not theirs. I am concerned and the Claims Investigator will not provide status or answer my questions in regards to the claim and recoverable depreciation. The Insurance company can’t assist since I have a lawyer representing me.

    Please, please help – ASAP!
    Thank you!
    Tom

  2087. November 2nd, 2015 at 5:18 pm #Jason

    Tom,
    No, I will not become involved when you have an attorney. If you have any questions or concerns, you need to direct that to your attorney.

    Regarding your contractor, it’s your home and you, and you alone, are the only one that can hire the contractor for work on your home.

  2088. November 3rd, 2015 at 6:16 pm #Guy

    Hello
    I appreciate everything you are doing to assist those of use with insurance issues and no resources to hire a public adjuster. Thank you.

    My Mother died in a house fire that destroyed our home Mar 2014, all that was left was the brick structure. It was a duplex and I lived upstairs and contributed $500/mth.

    the insurance has negotiated content loss and the insurance agreed to the final scope in July 2015 to have the house rebuilt. There were several code upgrades, etc which prolonged the process, some work was done last year but not much. Fortunately we had good coverage including replacement cost and code upgrades. I did not contribute to the delay.

    During the winter of 2014/2015 an electric heater was necessary from Nov – Mar. I submitted the electricity bills claiming the electricity cost for those months only as I thought I was expected to pay the basic monthly charge necessary to keep the electricity connected for the months where no or a small amount of electricity was used while the scope was negotiated and/or the house is being repaired.

    Instead of paying what I claimed the adjuster took the Kilowatts used for the entire year prior to Mar 2014, the last year of my Mother’s life and subtracted them from the Kilowatts used between Mar 2014 – Mar 2015 advising that I am only entitled to cost per kilowatt over and above what my Mother would have used in a year.
    Since there was only electricity used for 5 mths it is obvious that there would be no “over and above” amount.

    I understand this logic if my Mother was alive and renting a place to live and was then claiming the costs over and above her usual expenses. .. but my Mother is dead and would be incurring no utility costs.

    Nor do I think it is proper that he compared a 12mth period vs 5mth period – as mentioned he is only paying the kilowatts not the basic service, taxes, other fees, etc. If he had compared year to date $ to $ there may be at least some overage.
    I should mention that my electricity at the house was on a separate meter which is currently disconnected and was not included in the electricity used amount from 2014.

    Is the adjuster using the proper logic in figuring out the eligible amount of my claim.

    I have a few other questions but I don’t want to use up all your good will :), thanks again for all you do, I am sure you have diverted many from going off the deep end – me included.

  2089. November 4th, 2015 at 6:34 pm #Jason

    Guy,
    Explain to the adjuster about your concerns. They are human just like us. They should be prorating the amount used compared on a month by month basis.

    Frankly, look at the big picture. If they are rebuilding the entire dwelling and you have to pay for most or all the electrical use, that’s not something to dwell upon.

    But, remember, if you are the one handling the claim, the claim will not be settled until you and the insurance adjuster both agree to all the terms, conditions, and payments made.

    Also, be aware there are time limits upon replacement or repair and receiving all of the replacement funds. Specifically ask your adjuster what those time frames are and if they will make an exception (or have already made an exception) if you are going to be outside those time periods.

  2090. November 5th, 2015 at 3:00 pm #Amy

    Hi,

    First, thank you for having this website. My house burned down in a fire less than 2 weeks ago and we lost pretty much everything we own. Given what I’m reading on your website and others, I’m very anxious about the whole process. At this point, we have no idea what to expect, i.e., whether the insurance company will be cooperative or not, but to date, we have not received anything from them.

    Second, my question is about electronics lost in the fire. We lost several laptops, ipads/ipods, phones, tv in it. For example, we have an older Macbook and iPhone 4 that is no longer available at the Apple store anymore. I sent them an email asking whether we could purchase these items immediately and being conscientious explained that the models we had were no longer available. They came back saying we should look online to find alternatives… My problem with that is we want to buy our electronics from a reputable dealer, like Apple and Lenovo, which is what we normally do because I don’t want to buy the same model from someone at eBay only to find that the product is faulty/no good etc. The other option is to buy a refurbished model from Apply or Lenovo for an older product closer to what we had but two issues I have with that is: 1) since prices have gone down for most products, replacement value is now lower than what we originally paid, and 2) are we obligated to buy a refurbished product when our original item was new when we bought it? We are not trying to take advantage here but I would think we might be entitled to new items here versus buying things off craigslist and ebay, which might cause us even more headaches than we have now??

    What is fair/expected here?

    And, yes, I’m thinking of purchasing your book but would appreciate some insight on this first. Also, ironically, could I claim the purchase of this book under loss of use or anything since the only reason I’m having to purchase it is because of the fire? We have the typical coverage of house, personal property, loss of use and other structures.

    Thanks very much for your help.

  2091. November 5th, 2015 at 6:18 pm #Mary

    We had water damage in our basement from a septic back up. The Carpet, cabinets, flooring in Bath cabinet in bath along with insulation and 2″ft of sheet rock around whole basement and bath trim etc. My question is on the recoverable depreciation. Most of the depreciation is on the carpet and the painting. If I spend the amount on the carpet and the painting do they treat those 2 line items separate from the total claim . Or will I have to use the total spent when I was able to purchase the same cabinets for less than the ACV and my husband will install them. MY husband will do the plumbing.And all the trim I don’t understand how the painting was depreciated it is mostly labor and not paint. Thanks for your help. Mary

  2092. November 6th, 2015 at 7:33 am #FM Conte

    Amy, first get a copy of your contract and see if there are any limitations on these type of devices, often times there are. if there are dollar limitations shown, or exclusions with limitations that is the most you will get for that group of products. once armed with this i think you will be able to figur out best path.
    this is the best way to start once you know this provide this info,i know Jason will jump in.

  2093. November 6th, 2015 at 12:55 pm #Amy

    Hi FM Conte,

    I have sent copies of the pertinent pages of the policy back via email to you (I did not know how to post it on this or if I could). There do not appear to be any applicable limitations for the electronics, therefore I believe they should be covered under personal property “at actual cash value at the time of loss but not more than the amount required to repair or replace.”

    Thank you again for this website. It’s a godsend. I hope my question will help others as well.

  2094. November 8th, 2015 at 12:29 pm #Jason

    Amy,
    It’s very likely you have the standard HO-03 policy in which you have replacement coverage. Sure you also have ACV coverage but you probably also have replacement coverage since it is the most common coverage policy out there.

    It is standard to replace damaged items with new items that are similar in size, function, and grade. For example, if you have an Apple laptop, it is common that you can replace it with a similar type Apple laptop. Since it is common that people buy these items new, that is what you should expect. You do not have to buy used or refurbished. That’s not what replacement coverage is about.

    It is not necessary to send a copy of your policy since nearly every single standard homeowner policy is basically the same.

    I can’t imagine the cost of any insurance book being reimbursed under your loss of use. If you’ve experienced a loss of books, you likely won’t be required to purchased the exact same titles/authors so you probably have some flexibility in your replacement options.

    I don’t think there is a limitation, other than your coverage C limits, on electronic devices that are damaged by fire/smoke while located within your dwelling at the time of loss.

  2095. November 8th, 2015 at 12:33 pm #Jason

    Mary,
    You are able to recover the recoverable deprecation when the repairs have been completed. It doesn’t matter who does the repairs, but the expected total amount is what is shown in the estimate. That estimate represents the value of your claim regardless of who performs the repairs. You will have to demonstrate the repairs have been completed to the insurance company as part of the process to recover the recoverable depreciation.

  2096. November 9th, 2015 at 5:39 am #Mary

    Adjuster is saying I have to submit everything I spend to see the total before determining recoverable depreciation. Is that right. The carpet estimate was only for the sq footage of the carpet removed and obviously more carpet had to be ordered in order to do the job so I sent in that bill.I thought I would only have to send in what I wanted to recover. Not all my bills. If we do some of our own work ex painting I won’t have bills for our labor. The adjuster told me if we painted we would ge the homeowner rate instead of the contractor rate. Thanks!!

  2097. November 11th, 2015 at 8:50 pm #gerald rorabaugh

    does state farm pay for your computer as well as data you lost in fire. i,e, bank records,work history, bill paying, schooling

  2098. November 12th, 2015 at 8:32 am #Jason

    gerald,
    No, your homeowner policy covers for physical objects and property, not information, data, and electronic records.

  2099. November 12th, 2015 at 8:39 am #Jason

    Mary,
    Yes you will have a bill for your labor. Create a bill and send it to your insurance company, even if it’s written in pen on a notebook piece of paper.

    Sure, they may adjust the rate from contractor to homeowner, but it takes a homeowner a lot longer to prep and paint than a contractor. Also, a painter will have his own equipment and tools while you, as a homeowner, may not so there may be additional equipment and tool costs that your insurance company may need to consider.

  2100. November 17th, 2015 at 8:51 am #Andrea Hudson

    A few questions. I am in NJ.

    Do I still have the right to do my own repairs, if the mortgage company is on check? i.e. Can they demand I get a contractor?

    If the insurance company adjuster says I need to replace siding, even though it is extremely, mildly damage (all contractors have said the repair is a $100-200 repair) do I have to replace it, or can I repair it? I currently have alum siding that is circa 1985. I like the alum and don’t want it to mismatch and I don’t want vinyl.

    What happens when mortgage company loss-draft inspector comes out and sees we only repaired the small area of siding if insurance has paid to replace?

    I am not seeking anymore money (depreciation, etc) from them. This is the first check they send out, ACV is what I believe it is called.

    Let’s say insurance gave me a 4000.00 check and the repair is 1500.00, will they send me the remainder?

    And what if we did the repairs ourselves before mortgage got involved stating we needed to high a contractor?

    I know, I’m all over the place with my questions, but this has been a very confusing, daunting task and would love objective answers. Thank you.

  2101. November 17th, 2015 at 11:33 am #Jason

    Andrea,
    It’s your home – you can do anything to it that you want. You don’t have to hire a contractor if you don’t want to. Your mortgage holder doesn’t own your home – you do. They only provided you money to help purchase it.

    You are asking about what your mortgage holder will do. I don’t answer questions that aren’t insurance questions since that would encompass too much. I will venture to say if you incurred $1500 and the insurance company determined your house sustained $4000 in damage (or loss of value), then there is no reason the mort. company would send you the balance. It seems likely they would apply it to your loan. You may want to pose this question to your mortgage holder.

  2102. November 19th, 2015 at 1:43 pm #Matt

    Just about a month ago I was walking my dog on a property that I own when my next door neighbor approached. My dog got scared and bit. I don’t think it was intentional on the dog’s part, but the neighbor’s arm was bruised.

    Since then I have obtained a new home owners insurance policy from a different company ( for cost reasons… I never filled any claims before ) I have not cancelled the other policy because I fear a lawsuit could be coming regarding the dog bite.

    Obviously the cost of carrying two policies is much higher than I wanted to pay originally, but I am in a bind for now.

    My question is, if I cancel my older policy, can I still go back and file a claim with them for in incident that occurred while I was covered with them?

  2103. November 19th, 2015 at 4:24 pm #Jason

    Matt,
    Yes. Your homeowner policy is based on when the claim happened. If you were insured with company A during the dog bite and you cancel that insurance before a claim is made, that is ok. The claim will go to the policy that was in force on the date the bite occurred.

    Cancel your initial policy effective the same day you got the new policy. Under the wording of both your insurance policies, they are proportionate to each other. For example, if you have $300,000 worth of coverage under each policy, the coverage essentially moves to $150,000 of coverage for each policy. You would also be subject to both deductibles from each policy. Besides the reduction in coverage and the increase in deductible exposure, you are paying twice the premium. Having 2 polices is never a good idea.

  2104. November 20th, 2015 at 5:42 pm #zeth

    i am going through an insurance claim with rent a center for my front exterior door, their telling me their depreciating it. how can they depreciate it and make me pay for some of it if it wasnt for them i wouldnt need a new door?

  2105. November 21st, 2015 at 6:50 am #Jason

    zeth,
    Because the liability owed to you from someone who causes damage to your property is the actual cash value of the damaged item. Items depreciate over time and they don’t owe you the amount that depreciated. You had a used door and they are replacing it with a new door. In order to make it equal for them and you, depreciation is applied.

    If you still don’t like the situation, file a claim with your homeowner’s insurance. Your insurance will apply depreciation but when you replace the door, you can recover the applied depreciation since you most likely have a replacement policy. Sure you will have to pay your deductible but your insurance company will collect it from RAC and return it to you when everything is settled between both insurance companies.

  2106. December 3rd, 2015 at 8:10 pm #omar

    I had a house fire and have a quick question. Are supplemental claims typically paid in full to the contractor upon receipt of the monies from the insurance company.

  2107. December 3rd, 2015 at 8:31 pm #Jason

    omar,
    You ask, are extra claim money claims paid directly to the contractor when insurance company money is received by you from the insurance company.

    That question makes no sense. Fist you indicate if the money is “paid directly”, which means the money is receive by the contractor.

    When you say “upon receipt”, that means indirectly that you received the money.

    Money cannot be paid both directly to the contractor and to you.

    Please make your question or questions more specific and less contradictory.

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  2110. December 9th, 2015 at 7:00 pm #kathy

    Our roof recitly started leaking due to wind damage and had also ruin the room where it leak causing mold damange now. Our agent said we were coverage several times and not to wprrie about it. We had a adjuster came out and look and take pictures of the damage and he said we were not covered. A little advice please on what to do next..

  2111. December 9th, 2015 at 8:05 pm #Jason

    kathy,
    Your agent has no say about coverage – only your insurance company claims personnel can make that determination so I don’t care what your agent said.

    I have to rely on what your adjuster said since he took the information you provided in conjunction with the physical condition of your roof and interior to determine that the damage your home incurred is not covered.

    What should you do next? Without coverage, you should have the roof condition fixed first, and then next fix the interior mold damage. Of course, since there is no coverage, repairs would be at your expense.

  2112. December 10th, 2015 at 7:24 am #kathy

    The adjuster said since our agent said we was covered there was a error of amision claim would could do and the agents company would be responsible for damage for profinding false information. Would that be true?

  2113. December 10th, 2015 at 7:49 pm #Jason

    kathy,
    No. Just because someone told you to make a claim under the agent’s Errors and Omissions insurance doesn’t mean you have a legitimate claim under the agent’s coverage.

    One of the things you would need for your claim is for the agent to confirm to his insurance company that he did make that careless assertion to you. If he/she doesn’t admit that, then you have to prove it. If you are able to successfully prove it, then that error would have to fall under a coverage the agent has under that policy.

    So you ask would that be true that the agent’s insurance company would be responsible. He may be responsible for telling you the wrong thing and the damage you suffered as a result would be little to nothing. Your loss was actually not covered so you didn’t suffer a covered loss that the agent’s comments caused you any damage.

    If you want to spend more time for a loss (from your agent) that never materialized, then go right ahead.

  2114. December 17th, 2015 at 8:51 pm #Sara

    We experienced a water leak. A company came to clean up the water and determine where the water had traveled to. We received a check which we are of the opinion does not included all expenses, ServPro clean up.

    This is the detailed of our recent inquiry:

    We have been advised by ServPro of South Miami & Cutler Bay that they received payment of their invoice no. 1577 dated 11/5/2015 in the amount of $955.56. As mentioned in our previous email (detailed below) we inquired as to the adjustment to the total amount of our claim. We are of the opinion that the ServPro cost recalculates our loss and therefore the settlement amount should be $2,609.09.

    Please let me here from you soon as we have received no acknowledgement from anyone to resolve this question.

    This is the response we received:

    The payment made to Servpro was for the emergency drying services they provided. That payment was in the amount of $955.56. The payment you received was for the buildback or repairs. Servpro’s invoice and payment is independent of your settlement and would not change the amount you received. If you have any other questions, please feel free to give me a call.

    My question is when we reported the leak we were provided a claim number and was instructed to locate and stop the leak and then call a clean up service. I don’t understand how any part of this is independent from the claim. All expenses should be included in the total claim, less our deductible.

    Can you give me some guidance please? We live in Florida if that makes any difference.

    Thank you,
    Sara

  2115. December 18th, 2015 at 3:12 am #Jason

    Sara,
    It seems like you received instruction from your insurance company to find and stop the leak, which included emergency repairs. If you incurred this expense due to their instruction, they are obligated to pay it.

    Now, you indicate there is additional repair costs not paid by insurance. I have no idea if your loss is covered by your homeowner policy so the additional instruction you gave to Servpro may be an expense you seem to have incurred separate from the emergency response. Not all water damage to your home is covered by your insurance policy.

    I cannot provide more information with such little knowledge of your claim and loss experience.

  2116. December 23rd, 2015 at 1:26 pm #Nora

    Hi Jason:

    I am an E&O adjuster trying to evaluate an underlying property damage claim under DP3. A house flipper bought a house with knowledge there was a hole in the tile roof that was covered by a tarp. It is my understanding the buyer did not tell her agent or the insurance company about the hole, but they may have sent an inspector at some point.

    A rainstorm occurred 5 days after the closing, causing the tarp to be blown off, and allowing water to enter the home. Would this be covered under DP3?

    Thanks,
    Nora

  2117. December 23rd, 2015 at 7:36 pm #Jason

    Nora,
    A DP-3 policy will cover around 13 perils that can cause damage.

    Windstorm may be one of those perils but I don’t know enough details of the loss to be able to refer to a DP-3 policy to determine if there may be coverage. In fact, even if I had more information, I still might not be able to determine if there is coverage without also a physical inspection and the opportunity to interview the involved parties.

    You may want to direct your inquiry to the actual insurance adjuster handling the claim.

    As far as your role as E and O, the buyer needs to know what they are buying and it doesn’t matter if someone told him about the hole or not. The buyer has a duty to know what he’s buying by inspecting himself or , if he’s not qualified, to employ an inspector on his behalf.

  2118. January 1st, 2016 at 11:36 am #Charles

    While out of town, my hot water heater sprung a leak and soaked the flooring in closet, bedroom and bath. The restoration company called to dry out the home, drilled holes in the walls and kitchen cabinets to enable their equipment to dry these areas. Some of these holes were drilled in the same areas where the baseboards were. The adjuster stated that they would pay for new baseboards which would cover up the holes in the living room, bedroom and those drilled on the bottom of kitchen cabinets.

    These holes were a direct result of the restoration company as they had the intention of also handling the repairs. The fact that my insurance company expects me to accept the cover up of this damage and that, to me, it depreciates my home and is something that I must discuss with a realtor if I elect to sell, would be sufficient reason for a decrease in my asking price.

    Allow me, please, to discuss problems in the past with this carrier: The Hurricanes of 2005 that struck Florida totaled our home. We accepted a payout for the total cost of replacement but used those funds to renovate the home. The adjuster asked us to sign a statement indicating that no future claims would be filed and I believe, he expected us to continue with our payments. He further stated that he had tried to stop our check but it had been mailed and he wanted us to call him immediately when it arrived so he could pick it up. The insurance company would not allow us to select the company for repairs and sent their own people.

    Since that time, they have changed my policy to the way it was written prior to the hurricanes stipulating that “Wind driven rain” was not covered
    as well as, damage caused by water.

  2119. January 2nd, 2016 at 9:24 am #Jason

    Charles,
    Did you have a question?

    Regarding your baseboards and toe hick – Why would you have to discuss what is behind finish trim with anybody?

  2120. January 6th, 2016 at 6:59 pm #Antonio

    My parents house caught on fire, and they had home owners insurance so the insurance company sent a check for damages but my parents died before any work could be done on the house.. They still had an mortgage.. So what im asking is legally if i take over the mortgage are they still suppose to repair the home.. Can they reissue the check to remodel the home?

  2121. January 6th, 2016 at 8:40 pm #Jason

    Antonio,
    2 people dying at nearly the same time is incredibly odd.

    You can’t legally take over a mortgage. A mortgage is a pledge of property (home) to the lender for the use of money.

    “Are they supposed to repair the home?”. If your parents are deceased, they cannot repair their home. Only homeowners can direct repairs to the home.

    Who do you propose they reissue the check to? If there is a mortgage holder, the mortgage holder will remain on the check. I can’t imagine any person who could be added to the check other than an executor of your folks estate. Even then, the check would include the mortgage holder.

  2122. January 7th, 2016 at 9:42 pm #John Riggs

    Please help if you can how would I get homeowners to cover my stolen dirtbike it was on a closed porch when it was stolen and they adjuster told my mother on the phone that it can’t be covered because it’s not for farm use which I’m starting to think is one of there tactics to get the claim closed and I have 7000 still owed on it that I will have to pay for the next three years if they will not help I would like to reopen the claim one I learn more about this

  2123. January 7th, 2016 at 9:49 pm #John Riggs

    please comment any advise I had my dirt bike stolen from under my porch a couple months ago and filed a police report come to find out I didn’t have insurance on the bike itself my parents bought it for me when I was 17 and It just got stolen now that I’m 18 we still owe around 7000 for three years payment and my mother called and filled a claim and hey said they won’t cover it because it’s not for farm use and after reading this article I think it might just be one of their tactics to make them not cover it

  2124. January 8th, 2016 at 3:11 am #Jason

    John,
    Your parent’s homeowner policy specifically excludes motorized vehicles. A motorized vehicle needs its own insurance coverage policy. If none exists, there is no coverage for the stolen bike.

  2125. January 14th, 2016 at 2:59 am #Eva

    Hello,

    This weekend we had a pipe burst. We noticed because as I was showering I noticed the hot water and pressure was down. When I got out the shower I mentioned it to my husband. He went to investigate and noticed a hissing noise near the kitchen. He then went into the crawl space and saw a burst pipe flooding the crawl space. He took video. He came out and I showed him steam coming out from a crawl space vent. We immediately turned off the water and called a plumber. The plumber indicated it was a leak due to a pin hole in our copper piping that burst. He also suggested we call a restoration company as there was mold. The restoration came out and advised we had mold and we should contact our insurance company. We did. The adjuster came out 3 days after our first discovery. We provided him our story, pictures, the pipe, the video and our homeowners inspection. We have been in our home less than 30 days, first day on Dec 14th.

    Yesterday, a day after inspection, he called to say the claim was denied due to it not being an immediate burst and it being deemed a long term issue. However; we have proof of maintenance in the homeowners report showing that no leak or mold was present just two months again. We also are required to report as soon as we found out and we did, within 24 hours. The plumber and the restoration company agreed that it could have been caused by the pressure of turning the water lines off and on during moving and added the cold temperatures we having been experiencing. IF between the inspection and us moving in a leak was caused in our crawl space how were we supposed to know. We did our due deligence. Is there anything we can do?

  2126. January 14th, 2016 at 6:54 am #Jason

    Eva,
    It’s likely the water was not pressurized when the home inspection took place and the home inspector didn’t observe the failing pipe. Pipes don’t corrode quickly – they corrode over a long period of time.

    The event you described is not a burst but rather a corrosion pinhole leak. Your policy provides coverage for causes of damage that are sudden and accidental. The water leak is accidental but it isn’t sudden.

    Additionally, due to the presence of mold despite environmental cold temperatures, the failed pipe likely occurred prior to your initial insurance coverage date.

    It appears the denial by your insurance company is correct.

  2127. January 14th, 2016 at 12:28 pm #Eva

    The inspector checked the water pressure and noted it in his inspection report. He also ran almost all of the faucets/showers for a while prior to going in the crawl space. At the time of inspection he noted one leak. We required that leak had to be fixed prior to us purchasing the home and it was.

    The pipe had no evidence of corrosion. We saved the pipe to turn into the insurance company.

    The policy covers sudden and accidental that is in excess to 14 days. We were only in the home for 28 days at the time of the leak.

  2128. January 14th, 2016 at 2:35 pm #Jason

    If there is a pinhole in a pipe, there are signs that it is corroded. In fact, the pinhole is part of the corrosion.

    I don’t know to what you refer when you say excess to 14 days.

  2129. January 15th, 2016 at 11:12 am #Lori

    Jason,

    I recently had a pipe leak and the cost of the repair (if I have someone do the work and pay for “drying” myself) will be comparable to the deductible. How will it affect my insurance if the adjuster comes out but I choose not to use the insurance to repair the damage? I realize it will show in the database that I filed a claim, but will this a claim (for cancellation purposes if something else happens) if they didn’t have to pay out?

    Thanks,
    Lori

  2130. January 15th, 2016 at 11:30 am #Jason

    Lori,
    It’s a claim no matter what you do. It doesn’t matter if they paid out of not because it is still a claim.

  2131. January 25th, 2016 at 12:07 am #Amy

    I had a house fire that was a total loss and also damaged my yard. We had additional coverage for the trees, shrubs and lawn damaged, with a limit of $500 per tree etc. My 1000 sq ft of lawn was destroyed and at approximately $3.50 per sod, will cost about $3,500 to replace not including labor and tax. They only gave me $500. Is this standard? Are there any good arguments to fight this? This does not seem reasonable. Thanks.

  2132. January 25th, 2016 at 6:30 am #Jason

    Amy,
    The language in your policy regarding the trees/lawn is: “…but not more
    than $500 for any lawn or any one tree, plant, or shrub.”

    Your lawn was damaged and the policy said it would pay $500 for damage to any lawn. The insurance company got it right by paying you $500 for damage to your lawn.

  2133. January 27th, 2016 at 10:20 am #jack

    i have a bi -level home with both upper and lower finished total sq ft of 2328 sq ft but my ins company only listed the upper at 1164 sq ft will my ins company replace 2328 sq ft or the 1164 sq ft on the policy?

  2134. January 27th, 2016 at 11:00 am #Jason

    jack,
    If your coverage A is sufficient for the 1st and finished lower (basement) area, you should have adequate insurance coverage.

    Most homes have a basement and counting the above ground SF is how insurance companies look at most homes. You have an above ground level, and below ground level (partial below ground). Many people have finished basements, but some don’t. Coverage A is the most important aspect.

    If you still have concerns, talk to your agent about adequate coverage amounts for your specific home.

  2135. January 27th, 2016 at 12:47 pm #SERGIO ESPY

    Hello,

    Question. My claim was for $ 12k minus the publlic adjusters 20% public adjuster fee= $ 9600.00. Theyre about to cut a check but here is my concern:

    I have xyz mortgage company, ive heard in the state of Florida that if the claim is under $10k the mortgage company won’t hold your funds. Here is where my confusion kicks in. Do you think they will hold the funds before or after the 20% public adjuster fee? if the public adjuster collects his 20% it will go down the 10k $ threshold. what do you think will happen, anmy advice is appreciates.

    concerned homeowner

  2136. January 27th, 2016 at 2:33 pm #Linda

    We placed a claim for necessary repairs to our rental home (where our son lives) after storm damage. The State Farm adjuster came out and filed a claim on our behalf. State Farm sent us a portion of the money which we used to complete some of the repairs but life happened and we did not finish. That was probably about 4 years ago now. We are currently trying to complete the work. My question is will State Farm pay the balance of the claim even after all this time?

  2137. January 27th, 2016 at 3:17 pm #Jason

    Sergio,
    I don’t know who you heard your details of $10,000 from but as far as I’m concerned it is unsubstantiated hearsay – which is meaningless.

    The insurance company guidelines of not including a lien holder include the threshold of $2500 but each insurance company can deviate from that and modify that as they deem necessary.

    Your claim is based on the total amount of the damage. You can consider your public adjuster expense to be like paying a contractor who did no repairs to your home.

  2138. January 27th, 2016 at 3:19 pm #Jason

    Linda,
    No, you generally have 6-12 months to make the repairs and claim the recoverable depreciation.

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  2143. February 2nd, 2016 at 10:00 am #David

    My home was severe damage after get hit by a tornado. The insurance company is giving us 300K for repairs. I owe to my mortgage company 150K. Can I pay the note for my house with the insurance money? and with the rest of the money buy us another home? after that can I sell the lot where my actual home is? This is legal?
    Thanks for your advice.

  2144. February 2nd, 2016 at 10:48 am #Jason

    David,
    It’s not that simple. Insurance is generally paid on an ACV basis and then when the repairs are completed, you get the rest of the claim money.

    As far as the money you get, you can do anything with it that you want. You only have to be aware of the ramifications of not being able to collect the recoverable depreciation if the repairs are not completed.

    It’s your property so you can do whatever you want with it.

    It’s probably legal but I don’t know if you know how much you will get from your insurance if you do it your way.

    Talk to your insurance company and discuss your options for your claim settlement.

    If you want to know if it’s legal, you will have to talk to an attorney.

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  2146. February 4th, 2016 at 8:19 am #Jess

    Hi there – based in Texas and dealing w a flood claim on my mom’s home. The contractors have taken the repair estimates from the insurance adjustor and have agreed to that amount ($9,500). For me, if feels a little sketchy in terms of the two working so closely together. Am I better off delivering the repairs needed to an independent contractor, without the repair amount already listed? Or is there room for negotiation between the contractor and what the adjuster is offering?

  2147. February 4th, 2016 at 8:30 am #Jason

    Jess,
    It’s your mom’s home and she can do whatever she wants as far as hiring contractors. In fact, she is the only one who can hire contractors to work on her house. Consult with your mom if she wants you to help her narrow down with contractor she should hire.

  2148. February 4th, 2016 at 8:36 am #Jess

    Hi Jason – Yes, I understand that. But the question is about the relationship between the adjustor and the contractor doing the rebuild. The adjustor has agreed to a $10K rebuild, the contractor looked at that and said, “Yep, I’ll do it for $10K”. My question is if it is likely that I could get it done for say $8K and would be able to spend the additional $2K on upgrades or if the contractors suggested by the insurance company usually have pre-negotiated lower rates.

  2149. February 4th, 2016 at 9:38 am #Jason

    Jess,
    I don’t know if there is relationship between the adjuster and the builder. Some insurance companies guarantee the work of contractors but this isn’t always the case.

    There are only 2 parties in each agreement. Your mom is in a contractual relationship with the insurance company. When covered damage occurs to the insured property, the insurance company pays your mother. There are no others in that relationship.

    When your mom gets the repairs completed, that relationship will be between your mom and the contractor. When work needs to be done to your mom’s home, the contractor she hires does the work and she pays that contractor. There is nobody else in that contractual relationship.

    You are talking about upgrades. The insurance policy isn’t designed for the manipulation you are suggesting.

    It is careless to indicate you could get it done for $8000. This is water damage and I don’t know where you arrived at that figure. Further, I don’t even know if you have flood restoration experience and credentials.

  2150. February 5th, 2016 at 11:00 pm #Alan

    I had a fire in my house that destroyed roughly 70% of my house. At least in NY you do not have to rebuid your house but you can buy a replacement property instead and get paid RCV as long as new property cost (not including land and foundation) is at least as much as the one I am replacing. 1) Can I sell my damaged property first and then buy the new replacement proprty?
    2) Or I have to buy the replacement property first and then sell the damaged property?
    3) If I sell my damaged property say for 80K and my
    RCV to rebuild this property is 300k. Do I need to buy the new property (not including land, etc) for at least 300K or for at least $380k?

  2151. February 5th, 2016 at 11:14 pm #Alan

    I have paper documents that were damaged by smoke and soot due to fire in my house. I also have personal paintings painted by me. I am a reasonble artist, but the paintings would probably not fall under category of fine art. Destruction of fine art is not covered under the policy. However, I am asking for its cleaning and replacement (the reason I beleive fine art is not covered because it is impossible to replace it with the same painting etc). I would like paintings and documnets to be professionaly cleaned – -would that be covered by the insurance, as insurance covers cleaning of any other items.

  2152. February 6th, 2016 at 6:00 am #Jason

    Alan,
    Ask your claim adjuster about your options about the damaged property and a proposed replacement.

    Also, with your paintings, ask your claim adjuster about your options.

  2153. February 6th, 2016 at 11:25 am #Alan

    Jason,

    I was wondering if anyone has any knowledge regarding this. I would like to goto the adjuster after I am equpped with an opinion from this forum. As an adjuster works for insurance company and not me.

  2154. February 6th, 2016 at 11:26 am #Alan

    Jason,

    I was wondering if anyone has any knowledge regarding this. I would like to goto the adjuster after I am equipped with an opinion from this forum. As an adjuster works for insurance company and not me.

  2155. February 6th, 2016 at 11:41 am #Alan

    David,

    in response to #2144. At least in NY, if your house is severly damaged — you do not have to repair your house, but instead you can buy another house and sell your old house “as is”. As long as the purcahse price of the new house (not including land and foundation) is above RCV of the old house, the insurance should pay you ful amount of RCV. In your situation you want to pay off your mortgage and looks like buy less expensive house. Because the house is less expensive than what the insurance would pay you in RCV it may not work. I actualy had a similar question on this forum just yesterday # 2151 related to the same issue — still waiting for the answer.

    Alan

  2156. February 6th, 2016 at 12:09 pm #Alan

    I have had a fire in my house. First and second floor are very much damaged. The house of course is not livable. The basement area has less damage than first and second floor (mainly some smoke). The adjuster came over after the fire and determined that there is nothing wrong with countertops in the basement and there is only limited damage to sheet rock etc due to water used by firefigters. The house was sitting empty for four months while I am negotiating with insurance company. While the house was sitting empty (unheated etc) — some additional damage has occured to the countertops due to environmnetal exposure and I beleive there is additional mold damage because of the water from firefighting — that happened in these four months. Is insurance obligated to cover these type of damages that occurred AFTER the fire. As I belive I could not have done anything to mitigate it.

  2157. February 6th, 2016 at 12:41 pm #Jason

    Alan,
    It’s your home and you are the only one that can mitigate damage by doing it yourself or hiring somebody to do it.

    If you want to know if additional indirect and subsequent damage is covered to the fire/smoke damage, talk to your adjuster.

    If you don’t want to discuss your options with the claim adjuster, then hire an attorney. That way you will have someone working for you that can provide you with the answers to the kind of questions you have.

  2158. February 6th, 2016 at 4:48 pm #Kate

    I disagree with my insurance compnay on the amount they want to pay for my content items both for ACV and RCV. What are the recommndations to fight the insurance item content estimate? Does the insurance company require to disclose to me on how they determine RCV and ACV, as all they tell me that they used commercial software to do it. My understanding that the software requires input regrding number of years for depreciation and condition of the item for ACV — are they under obligation to disclose number of years and condition of the item they used in their software.

  2159. February 6th, 2016 at 5:09 pm #Kate

    If i do not like my current insurance adjuster. Can I request a new adjuster or ask someone else at the insurance company to provide second opinion on how the damages are determined. What is the success rate in having this type of the request approved by the insurance company?

  2160. February 8th, 2016 at 11:11 pm #Home Insurance Claims Advice | easy home insurance

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  2161. February 15th, 2016 at 11:58 am #Tom

    Hi water damage from broken pipe on main floor cause mold damage to cabinets walls, floor.

    abatement removed bottom ones.
    does the insurance redo top and bottom to make them match?

    Floor is the same upstairs, stairs, bedrooms, etc and no longer available.
    Does insurance redo floor everywhere it currently is to match?

  2162. February 15th, 2016 at 2:34 pm #Jason

    Tom,
    Your policy provides coverage for items that are damaged directly. That means if it is damaged, then it is considered. Upper cabinets not damaged are not damaged directly. The insurance provides no coverage for matching concerns, so no.

    Again, your policy doesn’t have coverage for matching anything. There is a standard of practice that replacement will go to the nearest natural break, door, elevation change, and similar items. Again, no.

  2163. February 16th, 2016 at 6:58 pm #Donna

    I have a friend who I’m trying to get some answers for. Her house was recently broken into and many item were stolen, most of which she had receipts for (she scans every receipt when she buys something). Because most of the items were purchased with cash the insurance company is asking for proof of where the cash came from to purchase those items, is that legal?

  2164. February 17th, 2016 at 6:34 am #Jason

    Donna,
    The insurance company is doing an investigation of the claim. They are allowed to do that. If verification is requested, your friend needs to provide it. Failure to provide the requested verification can result in the claim being denied for your friend’s failure to assist in the investigation of the claim.

  2165. February 17th, 2016 at 2:53 pm #Donna

    Thank you so much Jason! One more question, she thinks the main problem is an expensive watch that she paid cash for, is it possible to ask the insurance company to remove that watch from her claim?

  2166. February 17th, 2016 at 3:47 pm #Jason

    Donna,
    She can ask the insurance company to remove the watch from her claim but if it’s an expensive watch, why in the world would she want to do that? One item of her claim will not create a problem. If there are problems concerning her claim, it is more than just an item she’s claiming.

    If she would withdraw the expensive watch, why wouldn’t she withdraw other items of the claim as well, or actually the entire claim? If she is seriously thinking about withdrawing part of her claim, for what reason is she doing that? That will only raise more concerns for the insurance company. The insurance company will want to develop why she would entertain withdrawing an expensive watch from her claim.

    The insurance company may try to establish that perhaps the expensive watch was withdrawn from her claim because it was not actually stolen (or perhaps was never owned by your friend). If they arrive at that conclusion, they might try to develop that none of the less expensive items were stolen (or owned) either. Rational/reasonable people don’t withdraw expensive items from their claim just because some uncomfortable questions are being asked.

    I don’t understand why an expensive watch in which she paid cash for would be a problem. You said she purchases things primarily with cash. So what if she pays cash for low value items or a high value items? Cash is a legal form of tender and when it all boils down to the least common denominator, the dollar is what is exchanged for goods – not credit, services, or other means of barter.

  2167. February 17th, 2016 at 4:05 pm #Donna

    The reason for wanting to remove the watch was that it was bought with cash given to her husband after his mother passed away, she was one of those old timers that didn’t trust banks and kept a lot of cash at home! And I mean shoe boxes full of cash. The watch was $48,000 (Cartier) watch, so she has no way of proving where the cash came from

  2168. February 17th, 2016 at 5:02 pm #Jason

    Donna,
    Ok, so rather than your friend earning the money from a job or investments, she acquired the money because she was married to a man whose mother passed away from which they inherited the money.

    When people die, their assets are distributed by the courts through a will. If no will exists, the assets are distributed through intestate succession. If the cash came from the mother of her husband’s estate, it should be rather simple to establish where the cash came from that she used to purchase the watch. I don’t know why you would indicate she has no way to prove where the cash came from.

    Since she meticulously recorded all her receipts digitally for cash and credit purchases, providing documentation should be rather easy. I’m sure her detailed record keeping didn’t just start recently, right?

    I find it odd that someone, if not otherwise wealthy, would want or need a $48,000 watch. Acquiring a watch of that nature is similar to a person purchasing a $1.5 million Aston Martin One-77 while living in a 2 bedroom apartment when working as a receptionist making $35,000 a year. High-end purchases by people who aren’t affluent don’t make sense.

    What support can your friend provide that she actually purchased the $48,000 watch, and from whom – regardless where the money to purchase it came from?

    Just from what you’ve indicated, the $48,000 watch claim is a bit suspicious. It seems reasonable that the insurance company would have some questions about the entire claim. The insurance company can request a lot of information including phone records, credit reports, bank records, social media interactions, business records, etc. involving a claim. I’ve always relied upon the adage that if any individual part of an insurance claim is fraudulent, it makes the entire claim fraudulent. This may be what your friend’s insurance company is seeking.

  2169. February 18th, 2016 at 11:02 pm #dj

    So I live in california. I noticed a leak in my kitchen one night it rained. The next morning I called the insurance company. The referred a plumber and when he came out, he cut a hole in ceiling and said that my shower drain pain was the issue and that it was causing the leak. The adjuster came out and agreed with him. I had an appraiser come out and they said it would be around 10k to fix everything because they would have to take out everything in the bathroom. The insurance company denied the claim stating that it was a prolonged leak and For 3 months we didn’t use the shower and the next time it rained, water was coming down into the kitchen from the hole in the ceiling. I went on the roof and found that the flashing needed to be replaced and did the repairs myself. Now they are sending me a letter wanting proof that I fixed the drain pan or they are going to raise my rates. If I listened to their false claim it woulda cost me 10k. Can I request for the insurance company to fix my roof and the hole in my ceiling since their adjuster was wrong?

    Thanks in advance

  2170. February 19th, 2016 at 5:11 am #Jason

    dj,
    If you don’t repair the water damage, it may lead to additional damage. It is only reasonable the insurance company would want you to repair that damage.

    Your plumber and the adjuster agreed the water damage was coming from a failed drain pan. There is nothing false about that.

    Fix your roof? You said you already repaired it. Seems like a rather simple fix. Why would you want them to fix it again?

    You should repair the hole in your ceiling after you replace/repair the shower pan and address and repair the subsequent water damage. From the information you provided, the adjuster was not wrong.

  2171. February 22nd, 2016 at 8:12 pm #Anup

    Hello Jason

    My house had a leak that caused water damage to walls. The wall repair was paid for by the HOA. However at the time I was not aware of the scope of the work. The insurance company sent me a check before I could disclose that to them that the HOA will pay for the wall repair. What is the process of returning the funds that are associated with the wall repair. I have Ameriprise insurance.

    Thanks

  2172. February 23rd, 2016 at 5:38 am #Jason

    Anup,
    Your insurance company and the HOA insurance company should have already been in contact with each other about the overlapping loss concerns – before any payments were issued. It is not your responsibility to inform your insurance company what is being covered by the HOA insurance company.

    There is no process for returning funds related to the wall repair. Your policy does not require you to return claim funds sent to you, whether on purpose or by error.

  2173. February 23rd, 2016 at 7:33 am #Anup

    Hello Jason,

    Thanks for your reply. I understand that it is the carriers responsibility to get the requisite information from the HOA insurance carriers. They asked me to submit the CCR’s and I complied with the request.

    However- I am trying to understand the legality of having these funds since it was obviously sent by them without necessarily doing all the required homework on their part.

    Second question was in relation to the depreciation. They have the depreciation only on wooden flooring and the painting of the walls. I am trying to understand- what is the basis of this depreciation?

    Thanks,
    Anup

  2174. February 23rd, 2016 at 8:30 am #Jason

    Anup,
    You did everything you were supposed to do. It is out of your control to make others do things correctly.

    I can’t envision anything illegal about you being in possession of funds voluntarily and freely sent to you by your insurance company.

    Everything depreciates. Walls need to be repainted over time so painting is depreciated. Floors wear as well and have to be sanded, re-stained, and refinished to restore the floors. If the floors can’t be refinished, they eventually have to be replaced.

    Some items are not depreciated like disposal and/or labor since depreciation applied to these items wouldn’t make sense.

  2175. February 23rd, 2016 at 5:43 pm #Jamie Sherman

    had a leak in a luxury home i built for a homeowner,she filed a claim 6 months ago ,water damage to wood floor has spread throughout house,im trying to help homeowner out but there wanting to write a check for less than the estimate, and said we can ask for more money later,Its state farm, my estimate was for $60k , but after the hastling phone calls from adjusters,and meetings after meetings over the obvious , so i raised estimate to cover my time, now there offering $24k and $5,800, later .basicaly cabinets have to come out, granite etc to get to the real hardwood and plyboard underneath,with a $7k repaint of 10′ tall paint and glazed wall work,i dont trust them, there playing me,the gc that originally built the house against the homeowner im trying to help out,she called corporate office and cried to them and someone said just pay it ,here we are a month later playing the number game,after adjuster says she cant pay off of my estimate,what should we do?

  2176. February 23rd, 2016 at 5:55 pm #Jason

    Jamie,
    Your concern has nothing to do with insurance.

    My advice is to continue building luxury homes for your customers and run away from this situation immediately.

    If you didn’t grasp what I said, stop wasting your time and get back into the business of building homes for your customers. You don’t need the hassle. Get away from this situation without hesitation.

  2177. February 25th, 2016 at 12:24 am #Ali

    A very large tree went through the middle of my home due to a tornado in July. The claims adjuster came and went over everything thoroughly with me. The total amount to repair is a little over $200,000 without brickwork. My home is insured for $400,000. We discussed that a brick match would have to be done due to the old age of the house. My contractor stated that a company he uses would charge $55 a foot. This was written down by the adjuster. Based on the square footage of the brick that would have to be replaced, that amount equalled between $50,000 and $60,000. I asked the adjuster in front of my contractor and his partner if I chose to go with a similar brick that didn’t match, could I use the rest of that money in other areas of the house that weren’t damaged. He said yes. He stated”I don’t care what you do with the money.” I asked him the same question three more times to be sure. He gave me the same answer each time. I explained that I didn’t want to do anything wrong. He recently called to tell me his supervisor won’t approve that much money for brick without an invoice. I feel he lied to me. I have already torn out the old kitchen and ordered new cabinets. We have also ordered $11,000 worth of bricks that don’t match but I was willing to settle for. We are still out of our home and he seems to be stretching this out by not sending money for contractor on things already completed. Do I have any other options here? Do you think he is just trying to get out of paying the full amount but might negotiate and meet in the middle? Thank you for your time.

  2178. February 25th, 2016 at 5:48 am #Jason

    Ali,
    First of all, your insurance policy doesn’t provide any type of coverage for matching. Specific to your claim, it doesn’t provide for matching old bricks. Your policy should provide for removing the damaged bricks and replacing with new bricks. It seems that is the option you have chosen since you’ve ordered replacement bricks already.

    Your contractor is correct – he doesn’t care what you do with the money. If you go to vegas and spend it all on blackjack tables, that is your choice. You are the homeowner and you can do whatever you want with the funds you receive from the insurance company. You are the homeowner, if you want to spend a ridiculous amount of money to match the bricks, you can do that. What you do as the homeowner doesn’t change the value of your claim damage.

    Your claim adjuster is consistent that he responded 4 total times that you can do whatever you want with the insurance money your receive. So far, it doesn’t appear the adjuster lied to you. I don’t know how you draw that conclusion.

    At least they are allowing you the option to proceed with the repair of the bricks at $55 sf. with an invoice. That is seems to be generous. Although that seems to have always been your option, you seem to have chosen a different route, even though you were told they would pay for the $55 sf. repair.

    How your claim works is the insurance company should have paid you an ACV payment, then when the work is completed, you should be able to make a claim for the recoverable deprecation that was not paid initially. I don’t know what kind arrangement you have going on that you believe the payments are delayed. Either you have the ACV payment or you don’t.

    As the homeowner, you can do anything you want with the claim money you receive from the insurance company – so yeah, you do have options.

    What I think about paying, not paying, negotiating, etc. is irrelevant.

  2179. February 25th, 2016 at 5:54 am #Jason

    Ali,
    Correction: Not your contractor is correct – I meant your adjuster is correct..

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  2188. March 16th, 2016 at 1:27 pm #Tammy Suarez

    We filed a claim for water damage to a room and our kitchen with our insurance company last year and were told that the damage was due to the roof and that it would be less than our deductible to fix. Because we had a dry winter we waited on the repair and this year the damage is worse. My insurance want to close the previous claim and re open a new claim. How will this affect me in the future with the claim process?

  2189. March 16th, 2016 at 1:39 pm #Jason

    Tammy,
    I don’t even know why your claim was covered in the first place. But since it was covered, and under your deductible, nothing was paid.

    After a loss, it is your responsibility to take action to reduce or eliminate additional loss. If you fail to do this, that failure would be an exclusion for the additional damage.

    Your prior claim should be closed. If you now have additional damage relating to the same thing, that will be another claim on your insurance record. The situation I foresee is the one I just mentioned in the prior paragraph. However, if for some reason, they provide coverage for the additional damage, they will create an estimate, then subtract the amount of the original estimate of the first claim and that will be the basis for your current claim.

    I don’t know how your claims will affect you.

  2190. March 17th, 2016 at 7:20 am #Laurence Reines

    was a partial burn at my house and the insurance co. is paying for my
    temporary housing. The restoration co. is incurring a large utility bill,
    and my insurance co. says I have to pay because it’s a normal amount
    that I would normally pay for utilities. It doesn’t seem fair to have to
    pay for utilities that I didn’t incur.

  2191. March 17th, 2016 at 8:10 am #Jason

    Laurence,
    Extra electrical consumption is likely being consumed by your contractors Your usual water and electrical usage is likely less because you are using it at your temporary housing. I can’t imagine what other utilities you would be referencing since cable, internet, telephone, and heating would be minimally affected, if even at all.

    If the net increase/decrease actually amounts to a material amount, you will have to convince your insurance company to pay for it.

  2192. March 17th, 2016 at 10:21 am #John Nacco

    My homeowners policy was cancelled because of roof issues on a secondary house 3 months into the coverage as i couldnt afford 7000 in repairs i had to wait for spring to repair it myself..Anyway it was cancelled in dec my premium was 2800. and Jimcor was suppose to return my prorated amount which they determined was 1700 less 3 months charges.. i was told by Glen Wiggers they will return money but i have not heard from Glen and Jimcor will not talk to me because i am the customer. I have written a half dozen emails and called a few times leaving messages. I re insured thru Farmers and had to pay 2200 for full coverage and could have used my refunded money back. At this point who can i email in the government that regulates and overseas this type of harassment.

  2193. March 17th, 2016 at 10:56 am #Jason

    John,
    Farmers has been rated very high in customer claim dissatisfaction. You may want to continue your search for a company that has better ratings. Do some research yourself and find out which companies you should seek and which companies you should avoid.

    You mentioned two insurance agencies, Glen Wiggers and Jimcor. Do you even know with which company either Glen or Jimcor wrote your insurance coverage? That is who you should be communicating with to get your refund. You won’t get a refund from an agent – you need to get it from the actual insurance company who issued your policy. You did receive an insurance policy, didn’t you?

  2194. March 19th, 2016 at 12:53 pm #Chris

    Hi Jason,

    So, I originally posted on FYI, my original post was May 11th, 2013 at 11:14 pm.

    Basically, I owned an upstairs condo in Las Vegas, where the water heater sprung a leak and ended up causing water damage to the condo below mine.

    The date of the occurrence was Feb 5, 2013.

    The insurance company for the condo below mine was trying to collect the damages from me ever since…sending letters, phone calls, etc. To which I never responded to any.

    Well, I was just served court papers today (I live in California).

    First, can you confirm they only had 3 years to file against me? They filed this on March 7, 2016.

    Second, here’s the wording they used in the ‘CAUSE OF ACTION – NEGLIGENCE’

    “…Defendants owed to the public at large such as xxx insured the duty to use reasonable care in using and maintaining his property so as to not cause a leak from the water heater of the upstairs unit into the downstairs unit. Defendants breached their duty of care and were negligent in allowing corrosion and age to cause a leak from the upstairs unit into the downstairs unit, thereby damaging the downstairs unit and some of its contents”

    There was no corrosion and how can they assume that? How would I prove that as well, or how could they!!?!

    Any advice would be very helpful. Thanks again!!

  2195. March 19th, 2016 at 1:09 pm #Chris

    Hey Jason,

    I was wrong with the date of the occurrence….. It was April 13, 2013, so they are within the filing period.

    So, now I guess the question would be…Do you think they have a case?

    Thanks!

  2196. March 19th, 2016 at 4:36 pm #Jason

    Chris,
    I don’t think they do. However, since you are now sued for the damage, you need to respond to the suit and don’t let them secure a default judgment just because you didn’t contest their weak claim.

    The burden of proof rests with the insurance company to prove you were negligent, and therefore liable. You may need to hire an attorney to represent your interest in this so they don’t win the lawsuit and a judgment.

  2197. March 20th, 2016 at 5:57 am #Linda

    Your condo insurance should include liability coverage. You should have reported the claim. They would pay if they determine you’re responsible and provide the attorneys and defense of you’re not. They still might. Report it.

  2198. March 20th, 2016 at 6:37 am #Jason

    Linda,
    Chris’s condo insurance would definitely provide liability coverage if condo insurance had been in place on the condo.

    On 5-11-13, Chris wrote, “Meanwhile, I do not have insurance on my condo…” and would have already reported it if condo insurance was in place.

  2199. March 20th, 2016 at 9:08 am #Chris

    Thank you again for your help!

    One more question, as this is all new to me…what ‘type’ of attorney should I be searching for? I’ve been doing searches online, and I’m thinking it should be an ‘insurance’ attorney? Is that right, or is there something more specific that I should be considering?

    Thank you again!

  2200. March 21st, 2016 at 12:21 pm #Candace

    Hello.

    I live in Condo, downstairs unit, and my neighbors broke a water line in the wall that went from the wall to the fridge for an ice maker. Unfortunately no one saw it until my ceiling in my kitchen began to cave in. We have had adjusters and contractors at the house and are in process of trying to get it repaired. However we have hit a wall. All of the contractors we have seen are estimating at $2000 more than the adjuster has sent. Plus they are taking $1000 off the estimate for depreciation on paint and drywall and our agent is stating we need to pay the deductible. My neighbors have insurance and filed a claim because they had damages as well. My claim agent has started to get shady with me the more questions I ask. Which of course makes me nervous. We were staying in a hotel, but they had four people and two dogs in two small rooms with two beds only. We couldn’t do it anymore. I am not sure what i can do at this point. Or where to go. Feeling very frustrated.

    Thank you.

  2201. March 21st, 2016 at 12:36 pm #Jason

    Candace,
    The repairs need to be completed to your unit no matter what. Get the repairs completed. Have your contractor work with your insurance on the difference in the estimate and the actual cost to repair. Your contractor should be able to win that minor battle. The difference likely is your deductible and the depreciation applied.

    If there is depreciation applied to some depreciation items, you might be able to collect that depreciated amount when the repairs are done. Ask your adjuster is is an option in your policy. Most policies have that option.

    Your condo has to be repaired no matter who pays for the bill. Once you’re back in your place, you can get it figured out. Even if you don’t get it figured out, at least you’re not cramped into a hotel room.

    Don’t talk to your agent. He sells insurance. Talk to your adjuster if you have questions. Adjusters settle claims. Don’t blame your agent for not knowing the questions you ask because that’s not his specialty.

    Leave your upstairs neighbor and their insurance out of your problems. Water lines break and that doesn’t mean it’s your neighbor’s fault. Each insurance should take care of their own insured.

  2202. March 21st, 2016 at 12:40 pm #Jason

    Chris,
    Any attorney should be able to help you. The situation is one of the most simple legal concepts consisting of simple negligence/liability. Look for a liability agent, but just explaining your situation briefly with any attorney will help him understand your situation rather quickly. Find an attorney that you trust and you believe will find justice for you.

  2203. March 21st, 2016 at 3:56 pm #Chris

    Thank you again, I really appreciate all your help!

  2204. March 26th, 2016 at 7:04 pm #jessica petrenik

    I actually have three issues with this company and their unethical, and dishonest practices. From the very start of my interaction with them, they have not been forthright. Whether it be intentional or simply a result of their representatives not being thoroughly informed and educated, I can do not know.
    The first issue I have with them is that prior to obtaining my policy, I relayed that I wanted to have a policy which mimicked my geico one. I conveyed to AAA what was included in my geico policy. They assured me that not only could they match it, but I would actually have better coverage and not have to pay extra for the mold and fungi endorsement as it is included in their basic coverage.
    I have just found out when the representitve Jessie Gonzalez emailed me my policy coverage document on Tuesday march 22,2016, that this is not the case. I will be attaching the documents from my previous policy and also the ones from my current policy to show they do in fact do not match.
    Second issue is upon obtaining coverage, I informed them I would like my billing for the rental and car insurance payments to align, being that I had just paid 6 months of m y policy for auto, I wanted to pay the same for my renters. So my bills would be due at same time and I wouldn’t have to hassle with remembering different dfue dates. The representive accepted payment of 6 months premium, made no mention of a difference in their billing system for renters policy which would make my preference not possible.
    Within the week I receivced in the mail a billing notice stating that my next payment is due march 27. Thinking it to be an error of sorts, I called in, got told I would be called back after they found out what is going on, nobody returned the call. The issue took me 3 separate days and about 4 and a half total hours several different representatives, to find out that they don’t have a installment option similar to the one with their auto policy billing and regardless of my paying 6 months’ worth of what was owed, they will continue to send me a monthly bill. I feel this was deceptive on their part and incompetent, being that none of the many representatives and supervisors with whom I spoke was aware of this billing rule.
    Last and finally the main reason for my complaint.
    I recently have had a couple of back to back issue with the home I rent, 3 separate plumbing problems, 2 of which resulted in water flowing from my living room and garage ceiling causing me to have to place Rubbermaid bins underneath the leaks, for the most part of a week, and try to keep my 3 boys and the neighbors 2 boys who are always here playing away from lest they get sick or hurt. I called AAA and they told me I am not covered for this type of issue. So I took off work for the week while my landlord attempted to fix the problems which were causing the leak, and tried to manage to keep my kids schedules and lives as normal and routine as I could, which trust me was total chaos. Imagine 3 young boys and their 2 friends, 5 boys total ranging from ages 5-8 and trying to keep them away from these new obstacles which were randomly placed in their path throughout the Livingroom and garage. One upstairs bathroom unusable and having to shift all of my stuff from the leak areas to separate spots in such a hurry that it just caused an enormous unorganized pile in other rooms.
    About a week after this issue, and just days after my landlord leaves the country for a vacation, in Hong Kong, leaving me no emergency contact in case something happens, I ended up coming home from work at 1130 on Thursday evening March 17, 2016, to find that my fireplace was beeping and I instantly went and started ripping out plugs. You see the night prior my kids and I had smelled a strong chemical type smell, and though it was present we couldn’t find the source. We went to bed, got up the next morning, I took them to school like normal and came back to get ready for work, and when I walked into my home the smell was so strong, I almost passed out. I had to go outside and leave doors open to let it air out. I searched once more for source before leaving for work, and found nothing. I thought maybe due to fact that I am 6 months pregnant and sensitive to odors, maybe it was just the crafting items we had used to make my youngest sons leprechaun trap. I left for work and got home at 11:30 to find that my entire media center electrics, ahead now possibly been destroyed. I had a 6 outlet tap plugged into the wall and a power strip plugged into that which have had all my entertainment equipment plugged in for about a little over 3 years. Both were grounded and surge protected. I will enclose photos of each item and plug as well as the two adaptors, which are now so melted due to whatever failed in them that caused this.
    I called AAA on Friday to inform them of situation and the property damage as well as the possibility that it may not be safe, since at this point all I know is that I have a bunch of melted charred wires and there was marking on front of faceplate for wall outlet. They initially wouldn’t let me file for a claim, I was on phone with these people arguing and fighting with them from 1:10 to 5:30. I repeatedly asked for supervisors and got shoved onto hold for lengths of time, never got a supervisor. The representative told me someone will contact me 1-2 business days. Made no mention of the fact that their people have weekends off. I made several attempts throughout the weekend to get a status update both by email and phone and still got no response.
    I will be attaching these correspondences to this complaint as well. My weekend was pure torture. I was terrified for safety, and worried that when my kids returned on Sunday they would not be safe as I still had no idea what had caused the damage. I had a bunch of ruined useless electronics in my living room which was becoming quite depressing. I missed work from Friday, until Tuesday, waiting for these people to come evaluate. Saturday evening, my friend suggested I call pge to do a check, they came and found no problems with inside or outside lines breakers, etc. the outlet which was associated, was still hot, meaning live or working and showed no oddness in numbers, according to his little tool he stuck in the outlet. He suggested not using outlet or the items until a electrician came out. I then had an electrician come out who again advised me not to use my stuff, as they are physically damaged, plugs melted and charred and smell of strong electrical burning odor. He checked breakers and all outlets running on that circuit. He replaced 2 outlet receptacles as they were old worn and cracked, which he said happens, they do not last forever. The one which I had had my entertainment center stuff plugged, he said may have actually become worn from the weight of items I had plugged in. He explained some possible scenarios that may have caused it but said it is just really hard to know for certain. I paid him for the repair of the outlets, which he found that needed replacing. He advised me not to use a 6 outlet tap as they often have problems.
    I called all the manufacturers for my stuff and checked if I am covered with my extended warranties for repair or replacements, I am not. They advised me that due to damage of electrical cords and scent I should not attempt to use the items but should send them in to be analyzed. Which of course would not be free of charge and depending on what they find they will give me my options for repair or replacement and the cost, after it is determined the extent of problem and also if the items were what caused the issue.
    I conveyed all this info to AAA I sent them numerous photos documenting each item and the damage present. The adjustor finally came on Tuesday by which point I was totally frustrated beyond consolation. I showed her the pile of damaged stuff and the wall to which it was plugged, I explained the whole situation again she was here all of 7 minutes took 3 maybe 4 pictures, one of the pile as a whole one if the outlet that had had the media stand stuff plugged into it. One of the staircase outlet which was not a part of the issue and only got replaced because on a routine check of outlets running the same circuit to see if any others had damage or showed a cause for the problem, he noticed one outlet to be cracked, and replaced it as a precaution. She also took a photo of the wall tap, apologized for my experience, explained she doesn’t work weekends and she didn’t get the matter till Monday, and left saying I will receive a paper from Jessie to itemize my property loss. I had to literally call and email several times before this form was finally given to me, and then as I was finishing it up, Jessie tells me that only one thousand dollars is covered for my loss due to the fact that it was a increase in current or decrease which caused the damage. Unreal. These people refused to send any sort of professional out to determine the cause of problem, did not even touch nor hardly look at my property, came 5 days after the incident occurred and after I had had to remove all items from the living room to keep my kids from attempting to use them. This to me is unacceptable. If they are going to deny or limit my claim on this basis they should have to hire an electric forensic investigator or professional to determine that as well as have each and every one of my appliances analyzed by the expert or manufacturer who is familiar with the product to determine how why and what the damage resulted and is specifically. Otherwise they are literally just pulling whatever excuse is convenient for them to do the least amount possible to remedy the situation. Which seems to be consistent thing for them, if you use my history of interactions with them and their responses as a example. This is what I wrote to insurance department that deals with regulations. Triple a hasnt contacted me since tuesday regarding my claim to let me know any specifics or details. Today I get a check for 1000 dollars stating on back endorsement of this check constitutes acceptance of the offer of payment. Now I have never seen this before, is it because my damages amounted to over 3 grand and they are trying to only pay me 1000?

  2205. March 27th, 2016 at 9:59 am #Jason

    jessica,

    In your post, you mention, “Last and finally the main reason for my complaint.” This is an insurance help site, not a complaint site. Since your post does ask a specific insurance question, I will address that issue.

    They seem to be paying you the maximum available under your policy, while absorbing any applicable deductible. It doesn’t matter if your damage was $3000 or $20,000 – if the contractual agreement of the loss parameters cannot exceed $1000 (to which you agreed by the insurance policy contractual wording), that is all they are legally obligated to pay. They probably just want to get rid of you because you complain a lot and they think that is the best remedy for the claim you presented.

    You have 2 options at this point. Accept the $1000 check or refuse it. Only you can determine what you will do.

    You have to recognize that you expect and demand a lot and an insurance policy is a contract between two willing parties who enter into a voluntary agreement. If they determine they no longer want to participate in the voluntary agreement with you because of your time consuming demands and expectations, they have every right to cancel the arrangement.

    Additionally, when they have to formally response to the department of insurance to a complaint by you, your value as a customer declines significantly and they may deem your worth is not a value, but instead a liability. When a customer becomes a business liability, there is no benefit for the insurance company to continue the relationship and a non-renewal or cancellation becomes imminent.

  2206. March 28th, 2016 at 5:37 pm #Anne

    Hi,

    We lost our home in the recent California Butte wildfire. It was a total loss. Our insurance company was relatively good with payout for personal property, as well as Other Structures, but we are stuck on the dwelling. While other companies complied with Governor Brown’s request to expedite the claims process, and cut checks for the full replacement value of the lost homes, our company, Grange Insurance, apparently has no expedited process for declared disaster claims. It’s been an uphill battle just to get information, and much that our adjuster has provided us with seems questionable or unreasonable.

    1) The insurance company accepted the estimate from the contractor but the adjuster insisted that the extended coverage for code upgrades (which are included in our policy) did not cover fire sprinklers as we were choosing not to rebuild, and instead move out of state. She informed us that it wasn’t covered because sprinklers are not required in the state we are moving to. We were also told, that since we are not rebuilding, debris removal and demo were not included in the replacement cost. Am I incorrect in my understanding that replacement cost is just that, the total cost to replace my lost home were we to rebuild, without penalization for choosing to rebuild elsewhere or purchase a new home?

    2) Grange is refusing to negotiate a cash payout beyond the actual cash value of our home. We have full replacement cost coverage with extended coverage in case of national disaster. The replacement cost is more than double the ACV. They are insisting that we enter into a purchase agreement, they appraise the property, and they will then pay the remainder, excluding the appraised value of the land, improvements, and any additional structures. We are on the hook for those items. We did receive a payout-with depreciation for “Other Structures,” as well as a small amount for “Trees Shrubs and Plants” (which they listed as Category A).

    So, for example: the replacement cost for the lost home is 500k.
    We find a property for 500k. We make an offer and it is accepted. We then send the contract to the insurance company, they hire an appraiser, the appraiser values the home at 350k, the land at 100k and improvements at 50k. Not only do we not receive 150k of the replacement cost, but we have to play 150k out of pocket, putting us at a net loss of 300k in this transaction. How is this replacing our home? Under these terms, we would need to buy at least a 650k house just to get our full replacement costs.

    I have yet to speak to anyone who has ever heard of such a thing, and my real estate broker says she wouldn’t know how to write a contract for such a contingency. The real estate market in our chosen new area is very competitive, and sellers aren’t considering contingent offers when most properties are receiving offers within days of listing. We certainly aren’t going to enter into a sale without knowing exactly how much the insurance company is going to pay, and hope that their appraisal works out for us. We also are not in a position to afford to pay for the land, improvements, etc for a property where the house alone is valued at our replacement cost. When replacing a home, can the insurance compzny make such a stipulation, and is there some way to get them to negotiate a cash payout? We want to get on with our lives, but have been completely unable to find a way to work this out with them.

    3) Are items included in the policy under “Additional Coverages”, such as debris removal, trees and shrubs included in Category A?

  2207. March 31st, 2016 at 6:28 am #michelle Johnston

    We are selling our home and moving. When we called our insurance company(the Hartford, AARP) we were told they would not insure the home we are moving to due to our filing a claim some years ago over a chimmey fire that we were told had happen in our current home. We were unaware of the issue until we had the chimmey cleaned and no other damage occurred in our house. What can we do about this?

  2208. March 31st, 2016 at 9:22 am #Jason

    Anne,
    Your policy is a contract between your insurance company and you only. Your insurance company doesn’t need to listen to any input from a governor or anybody else concerning your claim. To make it simple, nobody can influence your claim outcome except your insurance company and you.

    1. You are overlapping issues about rebuilding your damaged home and replacing it with a home located elsewhere. Rebuilding your damaged house is much different than purchasing a different home, and the land upon which it sits. The land at your damaged house is not an insured element of your insurance policy. You own that land and theoretically land cannot be damaged.

    Since you are electing to purchase another home, you also have to purchase the land upon which that house rests. It’s your voluntary choice to purchase an additional parcel of land so instead of owning one, you will own 2 parcels of land. If you can’t afford another parcel of land, you may want to rebuild your damaged home, then sell it, and move so you can avoid owning 2 parcels of land at the same time.

    2. Your insurance company doesn’t have to negotiate anything. You should get an ACV payment for coverage A (your dwelling), and coverage B, other structures. When you purchase another home located elsewhere, you can make a claim for the recoverable deprecation, which is the difference between the ACV amount and the replacement cost.

    In your example, if you want to utilize your $500,000 replacement allowance, purchase a a home valued at $500,000. Realize your insurance will never pay for land so if the $500,000 home sits atop land valued at $150,000, your total cost for the home and land will be $650,000. Your net loss is $0.00 even if you have to pay $150,000 for the land because the value of that land is $150,000.

    If you want to limit your total payout to your deductible amount only, rebuild your current dwelling and other structures. When that property is rebuilt, sell it and then purchased another property somewhere else. Regarding your broker, if she is not capable of writing a contingency you require, find another broker that can. If you don’t want to be bound by the limitations involved in your insurance policy, you can use your ACV payment anyway you want and you can consider that your cash payout.

    3. You mention Category A, but you probably meant Coverage A. Coverage A is for the dwelling, B is for Other Structures, C is personal Property. D is Additional Living Expenses, and Additional Coverages are Additional Coverages.

  2209. March 31st, 2016 at 9:29 am #Jason

    michelle,
    Find an insurance company willing to insure your home. There are hundreds of insurance companies from which to select.

  2210. March 31st, 2016 at 12:33 pm #Anne

    Thanks for getting back to me. With regard to the Additional Coverages, the checks for item such as Plants Trees and Shrubs indicate that they were deducted from our Coverage A funds. So that is incorrect?

  2211. March 31st, 2016 at 8:05 pm #Jason

    Anne,
    It’s mostly for the insurance company actuarial and accounting areas to identify which coverage required the payment. The only time it would affect your claim is if you reached your Coverage A limit. Then the insurance company would need to make the appropriate adjustment. Claim money is money to you regardless of how the insurance company marked the payment for their record keeping.

    Insurance companies make payments using Coverage A, B, C, D, E, and F. The E coverage is for liability claims. Medical claims are paid under Coverage F. There isn’t a Coverage designation for Additional Coverages so the adjuster is forced to select one of the first four Coverages to generate the payment.

  2212. April 2nd, 2016 at 9:01 am #alan

    Jason,

    I am in a similar situation as Anne and would like to buy another house (not new) out of state as my original house was totaly damages by fire. Would selling my damaged house as is (mainly for the land value) in any way affect the insurance company pay out when I go and buy a new house out of state? Same as Anne I am not clear if the insurance should pay for debris removal in my old house if I am not planning to rebuild my old house. Would my ALE stop as soon as sell my old house but before I buy a new house?

  2213. April 2nd, 2016 at 12:42 pm #Jason

    alan,
    You can do anything you want with property you own.

    If your insurance company is ok with you replacing your home with another home located elsewhere, you likely have time limitations to complete the transaction and then request additional funds because you’ve met the replacement provisions of your insurance contract.

    I don’t know if they will pay debris removal. If the home is sold as is and you incur no debris removal expenses, then they wouldn’t pay. I imagine you can’t leave your home in a burned condition and you will have to do a minimum of debris removal. Talk to your insurance adjuster about your options and if there are any restrictions of your proposed plan.

    Work out the ALE with your insurance company. Of all the coverages contained in your homeowner policy, ALE is the most flexible.

  2214. April 4th, 2016 at 8:52 pm #Bobbie

    I have had my homeowners policy since 2007. I married in 2011 and moved 4 hours away. My agent was aware of this. My policy remained the same. My son moved in 2010. The house is in my name. My son makes the house payment. The electric bill is in my name and my mail is delivered there. I go back home often as my mother lives next door and my 3 children still live nearby. My house burnt , total loss, last week. The adjuster told me that I had the wrong coverage. I had homeowners but I needed a rent dwelling policy since I don’t live there full time and my claim will be denied. He said we needed to do a “reconstruction” on the policy to make it right so it could get paid. The reconstruction is still waiting “approval.” Is it possible that the claim will be denied because the home is not my primary residence. Does the reconstruction of the policy sound legitimate?

  2215. April 5th, 2016 at 7:50 am #Jason

    Bobbie,
    Unless your agent confirms he was aware of your move, you saying he was aware of your move is hearsay.

    When you initially took out your policy, you agreed to the following terms:

    H. Other Insurance
    This insurance is excess over other valid and collectible
    insurance except insurance written specifically
    to cover as excess over the limits of liability
    that apply in this policy.

    I don’t know know if you rent, own another home, or what your situation is. If your spouse holds a renters policy or a homeowners policy in his name or both your names, it doesn’t matter because you are married. So, if you are insured through another renter or homeowner policy, that insurance is primary and the policy covering the burned property is secondary (excess).

    In your primary and current dwelling, whether it is insured w/renters or homeowner, that policy provides coverage for your personal property located anywhere in the world. For example, if the deductible is $500 and the personal property coverage is $100,000 you will pay your $500 and that policy will provide for your owned personal property loss at the burned dwelling location. Proof of your ownership of personal property at the burned property will be strictly enforced so property of the tenant is not paid. If the burned property policy responds for your personal property damaged as excess coverage, that policy deductible will have to be met.

    The definition that develops coverage for you in a dwelling policy (current or for the burned property) is stated as follows:

    DEFINITIONS
    A. In this policy, “you” and “your” refer to the “named
    insured” shown in the Declarations and the
    spouse if a resident of the same household. “We”,
    “us” and “our” refer to the Company providing this
    insurance.

    This means you are the insured of the place in which you reside. It generically establishes the address in the declaration page of your policy as it refers to your residence address.

    With the wrong information in the declaration of the burned home, you are declaring the burned home as your residence. (But technically, you are declaring your current residence as the insured location instead of the burned property.) In any current policy, you are doing the same thing with your current dwelling address. You cannot have two addresses in which you reside. You reside at one and you visit the other. Each location is mutually exclusive of the other.

    Any policy you have will be excess coverage for the burned home, whether the policy associated with the burned home or your current dwelling. This creates a legal battlefield for the insurance companies who provide property coverage for each property in which both companies can simply avoid coverage by claiming their policy is excess coverage. Any current policy for personal property (mentioned above) could take the excess position as well and not extend any personal property coverage to you.

    You have duties to inform your insurance companies after a loss. If you have coverage at your current residence, you must provide them with the details listed below:

    B. Duties After Loss
    8. Send to us, within 60 days after our request,
    your signed, sworn proof of loss which sets
    forth, to the best of your knowledge and belief:
    a. The time and cause of loss;
    b. The interests of all “insureds” and all others
    in the property involved and all liens on the
    property;
    c. Other insurance which may cover the loss;
    d. Changes in title or occupancy of the property
    during the term of the policy;

    Because your son is not a resident of YOUR household, he is not considered an insured of your current household or an insured of the place at which he resides. Your son has no personal property coverage from any of your policies. His personal property would be covered only if he has a renter’s policy.

    Additionally, because your son is not an insured through any of your policies (because he’s not a resident relative), and he is found to be negligent/liable for the fire, he can be on the hook for any amount your insurance companies may pay for the loss.

    I cannot cover all the concerns because of the wrong policy for the burned property in this response. There are many including the difference in premium cost of a dwelling policy (non-owners do not protect the property as well as the actual owner, even if related to the owner) so for 5-6 years the premium you were paying is not respective of the loss exposure. The insurance company doesn’t have to approve this change – especially after a loss.

    Your question about being denied is possible. The change needed is not only legit, it’s necessary to avoid serious problems. Your claim(s) are going to be very complicated if your agent is not able to make the required changes .

  2216. April 5th, 2016 at 10:25 am #Lydia

    Hi,
    In December, a ice storm caused a conduit to break on the roof of our condo building which caused significant water damage into our top floor unit. A roofer had come and “fixed” the issue but turned out the leak was not sealed around the conduit. Due to the emergency, our electrician had to go up there to stop the leak and seal off the roof to prevent further damage. No photos were taken unfortunately but our electrician provided a sworn affidavit of what happened and confirming that the damage to the conduit, causing the leak, was due to the ice storm. We first filed a claim with our condo board insurance. They have denied our claim because of the lack of photos and said their master policy only covered water damage resulting from leaks in the roof. They also blamed it on wear and tear and said that our electrician told them this. Our electrician denies this and was not stated in his sworn affidavit. The condo bd insurance has sent us a denial letter basing it on non-coverage under the master plan and also due to wear and tear. This letter was actually dated prior to us providing the electrician’s affidavit. So basically the condo bd insurance gave us the run around and told us to provide evidence without any intention of even reviewing it. The insurance company is now refusing to correct the letter even though we argue that it will affect our claim with our own HOI. Our HOI is now also denying our claim based on wear and tear and also because the conduit is not covered under our policy. Basically, both policies (condo and our HOI) don’t cover conduits. I’m not sure how this could be that there would be a gap in insurance coverage. I apologize for this long message but a lot of money was spent during this emergency and we are desperate to try and at least recover something. We’re at the point of not knowing what more we can do. We are in Illinois.

  2217. April 5th, 2016 at 10:27 am #Lydia

    Sorry…I should also add that both insurance companies are pointing the finger at each other and are interpreting “limited common element” as being responsibility of the other condo policy.

  2218. April 5th, 2016 at 10:53 am #Jason

    Lydia,
    You are not insured under the HO association’s insurance. Only the HO association is.

    Your insurance should cover the resulting water damage to your unit unless the leak was a long-term leak From what you’ve written I can’t tell if that is the case but I’m leaning that way since both companies are denying based on wear and tear. If the conduit you reference is a common utility and not specific to your unit, your policy won’t even go near it.

    I don’t know what you can do.

  2219. April 5th, 2016 at 2:19 pm #Lynda

    Hi,
    I had an insurance adjuster come look at two water spots in my ceiling. He believes one of the water spots is from a loose ridge vent on the roof. The insurance company sent a check for the repairs. I had two roofers come look at the roof and one doesn’t see any visible issues. The other roofer thought it could possibly be a loose ridge vent but not certain and provided me with an estimate. It seems that the water spots may be a rare instance from hard rain of some sort. I would hate to repair the roof without knowing exactly the issue and would like to wait it out until the next rain to see if the water spots get worse. In the meantime, I’m not sure how I should handle the claim that is in process with the insurance company. What are your thoughts?

  2220. April 6th, 2016 at 8:57 am #Lydia

    Hi Jason,
    Thanks for your response. This is the first time a leak happened so it shouldn’t be a long term leak issue. Our HOI told us we needed to file a claim with our condo board insurance first as they are the primary insurance. So we did, and they denied our claim because we didn’t have a picture showing the damage despite providing a sworn affidavit. Both insurance are arguing that the conduit is, based on their interpretation, covered under the others insurance policy. The condo insurance (Farmers) is saying that the conduit is specific to our unit and is a limited common element. Our insurance (allstate) is saying that limited common element means it’s Farmers responsibility to cover. so both are pointing the finger at each other and we’re stuck in the middle.

  2221. April 6th, 2016 at 10:59 am #alan

    Jason,

    just to make sure that I interpret your response correctly. Say I remove the debris from the burnt house before selling it — would my insurance pay for it (as I have 5% coverage above policy limit for debris removal). Then I will be purchasing a new house and then asking insurance company to pay up to the full replacement cost of the old house for the new house (I hit the policy limit already).

  2222. April 6th, 2016 at 9:18 pm #Jason

    alan,
    Talk to your adjuster directly. Getting the information from me is asking someone not familiar with your claim and the allowances they are considering.

  2223. April 10th, 2016 at 10:30 am #Lynne Foster

    In August 2015 a large tree fell on my mothers 100 year old home in the State of Washington. The initial estimate for repair was $22,000, but a check was issued for 18,000 holding back the remainder for who knows what.It was paid within a month with the understanding that once repair was underway, additional damage could be found and the house would have to be reevaluated. A lot more damage was found. This reevaluation has been done at least 3 times in the last eight months and the house has yet to be repaired. Their final estimate on repairs has doubled but in the statement that was sent to us, they have now deducted $17,000.00 of the total $46,000 as depreciation. The house is not being replaced, only repaired. My questions is what are they depreciating, and is it legal to do so?

  2224. April 10th, 2016 at 5:00 pm #Jason

    Lynne,
    There is nothing illegal about your mother’s insurance company honoring the insurance policy wording and applying depreciation to the total cost of the estimate as indicated in the policy.

    The total amount of repair is $46,000. The depreciation is $17,000.

    Your mom should be paid $29,000 (less her deductible).

    Your mother has 6 months from the date of loss to inform her insurance company of her intent to make the repairs.

    Your mother has 6-12 months from the date of loss to make an additional claim to her insurance company for the depreciation amount of $17,000 after the repairs are completed. If this time limitation cannot be met, it is imperative that an extension is requested by your mother.

    The above time limits are standard and may vary by your mother’s policy. The only time a time limitation can be extended is by the insurance company in writing.

    If your mother’s insurance policy is a replacement coverage policy, the information above applies. If her policy is an ACV only policy, the amount your mother will be paid is $29,000, less her deductible and the information above can be disregarded.

  2225. April 12th, 2016 at 3:55 pm #Gordon

    Jason,

    Today, I had a reputable contractor that does foundation work come out and take a look at the foundation due to what I thought were settlement cracks. Come to find out that the construction of the joist and main beams were not constructed properly. They basically, instead of using I Beams, they nailed together two 2×10’s and then the joist are sitting on 2×2’s that are just nailed to the 2×10’s. The contracted said that this is not settlement issues but bad construction issues that are causing the cracks in the walls inside.

    My question is: After looking through my policy, I think it is covered. I am afraid to contact State Farm just to be told it is not covered. I am looking at $14k in new ibeams being placed and a jacking system on the new ibeams leaving the old 2×10’s in place. I am covered ? This is what the policy states:

    Dwelling
    . We cover the dwelling used principally as a
    private residence on the
    residence premises
    shown in
    the
    Declarations
    .
    Dwelling includes:
    a. structures attached to the dwelling;
    b. materials and supplies located on or adjacent to the residence premises for use in the construction,
    alteration or repair of the dwelling or other structures on the
    residence premises;
    c. foundation, floor slab and footings supporting the
    dwelling; and
    d. wall-to-wall carpeting attached to the dwelling.

    Please advise. Thank you sincerely for your help.

  2226. April 12th, 2016 at 4:08 pm #Gordon

    I found this in Section 1 Losses not Insured

    3. We do not insure under any coverage for any loss con-
    sisting of one or more of the items below. Further, we do
    not insure for loss described in paragraphs 1. and 2.
    immediately above regardless of whether one or more of
    the following: (a) directly or indirectly cause, contribute to
    or aggravate the loss; or (b) occur before, at the same
    time, or after the loss or any other cause of the loss:
    a. conduct, act, failure to act, or decision of any person,
    group, organization or governmental body whether
    intentional, wrongful, negligent, or without fault;
    b. defect, weakness, inadequacy, fault or unsoundness in:
    (1) planning, zoning, development, surveying, siting;
    (2) design, specifications, workmanship, construc-
    tion, grading, compaction;
    (3) materials used in construction or repair; or
    (4) maintenance;

  2227. April 12th, 2016 at 5:23 pm #Jason

    Gordon,
    Using your description of the cause as, “construction of the joist and main beams were not constructed properly”, that seems to fall under the exclusion section of your policy. It seems your second post identified the specific exclusion(s).

  2228. April 14th, 2016 at 11:46 am #A. Lewis

    I live in Oklahoma. My husband and I are separated, but still legally married. We live separately in two properties jointly owned. This is my question. Recently our storage unit was burglarized and everything in it was taken. I owned 1/2 the contents of that building. I did not know that an insurance claim had been filed until my adult son informed me. I have since learned that the entire claim was paid to my husband and he refuses to give half the claim to me. Do I have any recourse. Thank you.

  2229. April 14th, 2016 at 11:51 am #a. lewis

    I live in Oklahoma. My husband and I are still married but are living separately. I recently learned that a storage unit we rented containing various contents was burglarized. My husband filed a claim for the theft of the contents. I learned from my son that the entire claim was paid to my husband, even though 1/2 the contents belonged to me. I have asked him to pay me 1/2 of the loss and he refuses. Do I have any recourse?

  2230. April 14th, 2016 at 11:58 am #Jason

    a. lewis,
    Although you concern is minimally related to insurance, it’s really not. The matter is now a civil issue and your insurance has nothing to do with the theft anymore. Since you are married, you and he are a single unit. You can’t sure yourself, and you technically can’t sue your spouse. Short of him voluntarily giving you any money related to the claim, no, you don’t have any alternatives.

  2231. April 16th, 2016 at 3:34 am #Heidi

    Can you please tell me the meaning of ” The denial language based on a coverage investigation and lack of cooperation are being removed since coverage has been extended and your deposition has been taken.”

    This is in a “corrected notice”/ Notice of of Denial of Claim. ( I am 3rd party claimant injured on homeowners property) Does “coverage has been extended” MEAN just that? And if so, why the denial of claim since first reported loss??

  2232. April 16th, 2016 at 4:45 am #Jason

    Heidi,
    No, it’s out of context. In your first paragraph, I can’t tell who “your” refers to. I don’t know if the homeowner, you, or both provided a deposition. I can’t tell if the letter is addressed to you or you received a copy of a letter that was sent to the insured.

    The sentence, at minimum, is poorly written. Reference of deposition should precede the mention of coverage. Also, the deposition reference should be “completed”, not taken. Taken is a reference from the insurance company’s point of view and is not professional in its usage.

    In your second paragraph, your words in parenthesis, mixed capital-letter words, and the forward slash are making the interpretation of the letter more confusing than it was from the insurance company.

    If you want me to review the actual letter and provide feedback, you can remove your personal identifying information and attach the letter to an e-mail and send to the e-mail address, in orange letters, found on the insuranceclaimhelp website.

  2233. April 16th, 2016 at 3:07 pm #Christine

    I had a frozen water pipe burst flooding causing a lot of water damage. I got three estimates from reputable GC’s that work locally. They each came in not too far apart from one another. The adjuster came in $60,000+ below these estimates. She now wants an ‘independent” contractor of her choosing to come out and look at the scope of loss. My issue is it is a company that is 1 1/2 hours from my town where I know the cost of labor, etc is less than where I live. My concern is his price will be close to what the insurance company wants to pay. Will the insurance company use his quote to justify not paying me what my local contractors say it will cost to repair my home. I don’t want to use him. I want to use someone local. I asked if they could send someone closer and has worked on homes in my town…they told me they don’t have anyone to send.

  2234. April 16th, 2016 at 3:25 pm #Jason

    Christine,
    I don’t know the differences in the 4 estimates. Let them do their estimate with a contractor they choose. Have one of your contractors meet with the other contractor to make sure everybody is on the same page.

    You can choose any contractor you want as the homeowner. You just have to make sure you are not paying the difference between what your contractor charges and what the insurance company will allow. Another thing the contractors should all be using is the same estimating software. If that would be done, the differences would be minor.

  2235. April 22nd, 2016 at 1:24 pm #Quinn

    I dealt with an adjuster from my insurance company re: a roofing issue. He denied our claim, then shortly after we received a letter stating that our roof and all flashing would have to be replaced (at our own expense). In addition, they are insisting that all knob and tube wiring (very common in our area, our insurance co was aware of its existence, and we have had a rider in our policy specifically for this wiring since we first insured our house 7 years ago) be replaced as well, again at our own cost. I am willing to eat the cost of the roof and flashing, although I feel like this is a case of our insurer being punitive because of our previous issue; however, I would like to write a letter requesting that our long-time rider on the knob and tube wiring continue to be honoured. I simply don’t have the money to replace the wiring at this time, in addition to replacing the roof. I would prefer to stay with my current insurer, despite our issues and my dissatisfaction with them, as a public adjuster has advised that our insurance company has ‘blackballed’ us from getting another insurer. Better the devil you know, and I’m sure our rates will be better with this company, with whom we have dealt for approximately 15 years and in that time made only two claims (one home, one auto) until the roof issue. What can I say in my letter to convince them to compromise on the wiring??

  2236. April 22nd, 2016 at 7:14 pm #Jason

    Quinn,
    Nothing. Redo the wiring. Get another insurance company too. Your public adjuster has no idea what he’s talking about. You have no idea if your rates will be higher or lower with another company until you look for other insurance.

    Your adjuster is not punishing you for anything. What your adjuster did was informed underwriting of their concern about your wiring. The underwriting person reevaluated your risk and decided they no longer want to insure your property unless you update the wiring.

    The possible compromise you will have with the wiring at this point is to update the wiring, finding another insurance company, or both.

    As a rule of thumb, everybody should be comparing insurance rates with other insurance companies every 3 years. In the time you were insured with this company, you should have compared rates 5 different times.

  2237. April 23rd, 2016 at 1:52 pm #Debbie Campbell

    We had a bad hail storm last Monday evening….lots of damage to our home. I have spent many hours with Insurance Agent, Claims adjuster, Restoration Service, roofer, band (also hail damage to car), my question is:

    I am documenting all my cleanup hours, can I claim the hours that I have worked to clean up my house…. glass, water, vacuum, debris, moving furniture, etc. 74 hours between myself and my husband.

    Can I claim the hours and if so how?

    thank you

  2238. April 23rd, 2016 at 1:55 pm #Jason

    Debbie,
    Create an itemized billing, with hours, and task you did, as well as what your husband did, assign an hourly rate to it and present it to your adjuster as part of your claim.

  2239. April 23rd, 2016 at 2:04 pm #Debbie

    Will they accept all types of cleanup, vacuum, sweeping, watering down driveway (glass), moving furniture, dusting, wiping up messes (water damage, boarding up windows, tarping roof, picking up debris outside, phone calls? is there anything I should leave off….I logged my total hours each day, but have not actually broke it out. I do not want then to deny because I put something I should not have.
    how much should I put per hour 10/20/30? I have 74 hours to claim, will they question the hours?

  2240. April 23rd, 2016 at 2:21 pm #Debbie

    what rate should I use? I live in Dallas TX area?

  2241. April 23rd, 2016 at 2:52 pm #Jason

    Debbie,
    Use your discretion and be fair about it. If it’s activity due to the storm, then ask to be reimbursed.

    If they don’t agree with something, it’s easy enough to remove that task. If they don’t agree with a reasonable dollar amount per hour, they can easily change that too.

    Why would they question the hours? If you have 60 hours watering down the driveway, they better be questioning it.

    I can’t tell you what to you for a rate. That’s best determined by you.

    If you want some feedback about a rate, ask the adjuster. Tell him you’re thinking about (blank)$rate, and if this is reasonable.

  2242. April 23rd, 2016 at 2:59 pm #Debbie

    yes, interesting enough, i asked without giving an actual number or hours and he said, we do not pay for you to clean up your own house. I thought that was an unfair response.

  2243. April 25th, 2016 at 12:47 pm #Sara

    We bought our house five years ago using my husbands VA loan. It was inspected and everything by the VA and passed. However here we are five years later with major structural damage, the need to replace most of the sewer pipes, and electrical. As well as so many other things that are cause our house to become unlivable. Can we file a claim with our insurance agent to have these things repaired? We can’t afford to get a loan through our bank and yet I’m terrified that if an inspector came into our home right now our house would be condemned. Please help!

  2244. April 25th, 2016 at 1:37 pm #Jason

    Sara,
    You didn’t mention a sudden and accidental cause of damage happening to the home so it doesn’t seem your home condition would be covered by insurance.

  2245. May 1st, 2016 at 5:51 am #Katherine

    Hello i am currently trying to help my friend who is currently incarcerated and she filed a claim on July 21, 2015 date of loss of her dwelling. In September she was incarcerated and still in there. When the property was involved in a fire and the status of the home was in forbearance. However when she had filed the claim , a Property Claim Rep. interviewed her and recorded her statement within 2 days after the claim. They provided a temporary living for her at a very low budget motel and with in 2 to 3 weeks was approve for an apartment. Mercury Ins. @ claim dept. provided her a check for the amount of $1500. basically for down payment and first month of the rent. That part was done until the incarceration approximate on the end of Aug. or the beginning of Sept. of 2015. My friend gave her testimony to the Claim Rep. However, the attorney for Mercury Insurance has their own attorney and they scheduled an appoint in jail to have an under oath staement. This took place in Nov. 12. The named insured has been going through a huge emotional disstress, not having her son just curently found out the man that she cares for so much ignores her and cousins and other friends that she had helped out she helped them. Just FYI she has a very big heart and helped alot of people to stay at her house for they did not have anywhere else to live so she would allow them to stay at her place, nevertheless she has been in jail sincce Sept. and the mortgage company is proceeding with the loss of the house for non payments and having the houe auctioned on May 12, 2016. Could the mortgage company do this while the named insured is still carcerated, eventhough; the named insured did fill out the forbearance form and My friend Her court appointed attorney that was given to her apparently is trying to charge her for arson. Wow istead of trying to help her. Apparently on one of the court hearing they had a Fire Marshall to give hi statement and his statement was only based on opinion . WOW WOW not facts. Please help me help my friend for time is running out and her house is being auction on May 12. She gave me power of attorney so that i could help from outside. Mr. Ron Cercone please what i did to do for her. I would truly dislike for an innocent young woman to go to prison for the charge ARSON and imprisonment for 6yrs. When she was even in current remolding her home for she had put new tiles and painted the interior. She was even looking for a job for she wants her home saved and being stubborn asking family to help.

    Mr. Ron Cercone I would grately appreciate for an immeadiate assistant of your knowledge regarding this issure that my friend is having and loosing her home on the 12th of May to an Auction. What can i do to assist her and to prevent her to go to prison. I am asking for guidance and your expertness. God Bless and thank you for taking the time to read this and hopefully a response as soon as possible for time is truly crucial.

  2246. May 1st, 2016 at 6:33 am #Jason

    Katherine,
    There are so many things that I need to be clarified for you. Your friend was in jail for something other than arson. In addition to the reason she is in jail, she is now charged with arson for her dwelling fire. Besides arson, she is likely facing charges related to insurance fraud. Her court appointed attorney is representing her and IS NOT charging her with arson – the prosecuting attorney is. There is a lot of evidence against her if an arson charge is proceeding. The fire marshal cannot provide anything other than opinions which are based on facts he determined after the fire occurred. There are many tools and processes they have at their disposal to arrive at an opinion of arson. An opinion of arson is pretty much equivalent to direct evidence and is legally accepted by courts all over the country.

    Your friend has already lost her home. The mortgage company has control of her home and with that control, they are auctioning it in less than 2 weeks. Other than your friend paying all the past due amounts to stop the foreclosure, including auction, there is nothing she can do. If she could have paid to remove it from foreclosure, she would have done that already. She has no job and is in jail so this isn’t an option.

    The only way you can save the house for your friend is by paying the past due amount, interest, penalties, and all the costs incurred due to the foreclosure action. As a reasonable person, you aren’t going to do this – otherwise you would have done it already. As a reasonable person, you know paying all that money would not be a rational effort for someone who won’t need a house for at least 6 years or more.

    Lastly, your friend’s issues are completely legal in nature due to her financial situation (among other criminal concerns). Her concerns are not insurance related other than her alleged use of insurance to help her out of her financial situation. The certainty of arson by an insurance company to recommend arson charges to a prosecuting attorney is enormous. A trial is merely a formality to an otherwise nearly certain arson conviction. Your friend needs to focus on legal issues and not be distracted by the foreclosure because that should be the least of her worries.

  2247. May 4th, 2016 at 8:25 pm #Betsy

    My neighbor and my family both have country financial insurance. My brother cut down a tree in our yard and a small part of it hit his house which caused his gutter to come loose. We did not want to file an insurance claim bc we had a licensed contractor look at it and give us an est of under $200.00 to fix it which we were happy to pay for out of pocket and we gave this info to the neighbor. now all of the sudden our neighbor is filing an insurance claim and his insurance is demanding we pay $6,000 for the damage! What can we do? This is stupid! that man is trying to hood wink us into paying to reside his house! Help please!

  2248. May 5th, 2016 at 3:09 am #Jason

    Betsy,
    If your brother lived with you at the time he cut the tree down, file a claim with your insurance company so they can address or pay the claim on behalf of your family.

    If your brother didn’t live with you, give the demand for payment to your brother and let him file it with his insurance.

    If there is different situation than the one I gave information about, write again.

  2249. May 12th, 2016 at 10:06 pm #Patty

    I had a leaking pipe in the basement wall that caused mold and carpet damage in our finished, carpeted basement. The damaged carpet and padding was removed. When my rebuild guy did his estimate, he included the cost to replace more than just the basement carpet. The same carpet extends up the steps to the first floor where the same carpet is in the living room. It continues up the steps to the 2nd floor where the same carpet is in the hallway and in 3 of the bedrooms. With the exception of the bedrooms, there are no doors or anything else to break up the carpet. It’s a continuous run.

    I understand the 3 bedrooms are probably out of the question & I’m not arguing about that. However, I believe all the other carpet should be replaced assuming I have the right to have my home returned to its pre-damaged state. We intentionally kept the carpet the same color since breaking up the flow with different colors would be very unattractive in open areas. In the basement, there is also another very small carpeted room that has been excluded. The room has a door, however, it will look really bad for that room to have different carpet since that door is always open.

    My adjuster is wanting to replace the carpet ONLY in the large room in the basement. It will look like a patch job since the large room, the steps and the small room will meet with different carpet. Seems to me I am not being properly indemnified for this loss. The adjuster, of course, has the typical response – “the policy only covers for a direct physical loss.” That explanation is full of holes and does not hold water in my opinion. Courts in FL have opined that when something in the area is a continuous run, the policy should cover the replacement even if parts were not damaged.

    Can I get your opinion and suggestions as to how best to proceed? Thank you. This must be a common occurrence in HO claims.

  2250. May 12th, 2016 at 10:09 pm #Patty

    I had a leaking pipe in the basement wall that caused mold and carpet damage in our finished, carpeted basement. The damaged carpet and padding was removed. When my rebuild guy did his estimate, he included the cost to replace more than just the basement carpet. The same carpet extends up the steps to the first floor where the same carpet is in the living room. It continues up the steps to the 2nd floor where the same carpet is in the hallway and in 3 of the bedrooms. With the exception of the bedrooms, there are no doors or anything else to break up the carpet. It’s a continuous run.

    I understand the 3 bedrooms are probably out of the question & I’m not arguing about that. However, I believe all the other carpet should be replaced assuming I have the right to have my home returned to its pre-damaged state. We intentionally kept the carpet the same color since breaking up the flow with different colors would be very unattractive in open areas. In the basement, there is also another very small carpeted room that has been excluded. The room has a door, however, it will look really bad for that room to have different carpet since that door is always open.

    My adjuster is wanting to replace the carpet ONLY in the large room in the basement. It will look like a patch job since the large room, the steps and the small room will meet with different carpet. Seems to me I am not being properly indemnified for this loss. The adjuster, of course, has the typical response – “the policy only covers for a direct physical loss.” That explanation is full of holes and does not hold water in my opinion. Courts in FL have opined that when something in the area is a continuous run, the policy should cover the replacement even if parts were not damaged.

    Can I get your opinion and suggestions as to how best to proceed? This must be a common occurrence in HO claims. Thank you.

  2251. May 13th, 2016 at 7:41 am #Patty

    By the way, I am not in Florida. I just shared that because I came across some cases online. I’m in NJ. Other than the clean-up, the claim has not been paid. I’m considering filing an appeal.

  2252. May 17th, 2016 at 5:42 pm #Tracey

    I purchased a new manufactured home December 2011, this past weekend I noticed the hallway bathroom had water along the baseboard. I cleaned the area and turned the water off to the toilet. Next morning, there was water again, so needless to say it wasn’t the toilet. I went to do laundry, which adjacent to the bathroom and the wood under the floor buckled. Contacted my insurance company to start the claim and was told to have a plumber come out and repair the leak.(take lots of pictures). Plumber found the leak, it was leaking from the shower inside the wall, and also found that I’m infested with mold in and under the home. Had a company come out this morning to assess the mold, they are going to knock three walls down, tear up flooring, rip apart my bathroom and laundry room, etc, etc. I just read my policy and it states that if it was sudden and direct, it would be covered. But, if it was an ongoing leak, it would not be covered. How would I know there was a leak in the wall?!?! Do i have a chance?

  2253. May 20th, 2016 at 6:26 pm #Ashley

    In June 2015 the house I was renting was burglarized. I reported the loss to my insurer. The policy was only a few weeks old so I knew from the get go that I was going to face an uphill battle with the claim.
    I had been researching to buy renters insurance since November 2014 and offered the emails and quotes to my insurer as a way to show that I was being honest with this claim.
    I have given multiple recorded statements and sat for an EUO in January 2016.
    My question is some of the stolen property that I have on my statement of loss showed up in my personal property that had been illegally held by my former landlord. This property was out of my control for over 6 weeks, only upon obtaining a court order that allowed me to retrieve my property did I discover the “stolen” items. I have also uncovered numerous texts and emails between my landlord, former roommate and ex husband in which it appears that they are trying to conspire to get me arrested for insurance fraud. I have a text written by my forner roommate stating that she has re-entered the house we had lived in together (same house that the burglary took place in 4 months after she moved out) and removed items that weren’t hers. While she isn’t specific on what she took, I believe that she had some part in the burglary and is trying to help my ex husband by placing items they know I have reported stolen back in my things so it gives the appearance of fraud. She also admits in texts that she had gotten my passwords for my facebook and emails while we were still roommates – so she would have access to my typed statement of loss and supporting pictures and documents. What do I do at this point? I am scared to approach the insurer because I believe that they are approaching this as intentional fraud. My landlord admitted that she went through all of my things because my ex husband had convinced her that I was stealing from her. She didn’t find anything of hers but told me that she did supply my ex with photos of my personal belongings because he was concerned that he saw things that had been reported stolen. The level of deceit is very hard to believe and I am afraid that my insurer is going to look at me like I am the crazy one and that I am trying to cover my tracks with this story. Do I need to hire attorney? Should I call the detective who was investigating the burglary? I don’t know what to do and am scared to make a move in any direction! One of my friends said that if I got and attorney it would almost be admitting guilt. Someone else said that I should just withdraw my claim to protect myself from a insurance fraud criminal charge. Can you offer me any advice? I am scared to even call an attorney. June 14th is the one year loss anniversary. The attorney that did the EUO has asked me me twice now to return the Sworn Statement with any changes to my testimony from the EUO. I have not returned it yet because I am scared that they are just waiting for that piece to prosecute. I gave truthful testimony at the time of the EUO – it was just over 7 weeks submitting to it that I discovered the items tucked in my things that I just moved. I just need an advocate – not sure if that is an attorney, my insurer, the police? Please help!

  2254. May 25th, 2016 at 4:09 pm #Jason

    Patty,
    Your adjuster is dead-on correct in what should be done. As you know, doorways are a good threshold point to change carpets, regardless if the door is open or closed.

    Also, the bottom of another barrier is the bottom or top of stairs. The adjuster did exactly what is appropriate.

  2255. May 25th, 2016 at 4:22 pm #Jason

    Tracey,
    The requirement for coverage is a non-excluded event that is sudden and accidental. You are aware the policy does not cover an on-going leak or one that is not sudden.

    The coverage requirement does not indicate whether or not you need to be aware of the leak. The extend of damage, including mold, and extend of damage to home materials will determine if it’s sudden or long-term damage.

    I don’t know the specifics of your claim or the actual condition of the affected materials so I don’t know what you claim outcome will be.

    Whether the damage is covered by insurance or not, the repairs are necessary to preserve your home.

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  2257. June 2nd, 2016 at 8:43 am #Randy

    My parents had a tree fall through their house with a recent storm. The tree damaged the roof severely and allowed water ingress. The insurance adjuster seems to be ok with these repairs. The question I have is…the tree damaged their weatherhead and the lines to the main box. In the process of repairing this the contractor is saying the whole house needs to be rewired as part of the original repairs. Is the insurance responsible for these repairs and if not, can they force you to perform the repairs before giving you money for the remaining repairs?

  2258. June 2nd, 2016 at 7:01 pm #Jason

    Randy,
    You are asking if the house electrical needs to be updated. No. Per code updates, if a significant portion of the electrical system is being replaced, then all of it must be replaced.

    Reconnecting electrical power to the home is not a significant portion of the electrical system.

    There are no repairs other than reconnecting the electrical service so I don’t know why any money would be held up for any of the other repairs.

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  2269. June 14th, 2016 at 9:19 pm #Kevin

    Hi, we recently suffered a total loss house fire. The insurance company has paid up for the structure portion of the home. I was wondering one day so I called my agent and ask him if it would be a good idea to cancel my homeowner’s policy because it was already lost. He snapped it right up and took it away and cancelled it and now I’m beginning to think that that might not have been a good idea. Do I have anything to worry about moving forward with anything that might come up or is it all based on the fire that happened? I know if there is a liability with tearing the structure down but I’m going to get a Builders risk policy for the contractor to build the home back. The demo contractor will have to have a policy of his own to cover anything liability wise that might happen. I am just wondering if I’ve made a mistake and need to hire a lawyer or what?

  2270. June 15th, 2016 at 6:20 pm #Jason

    Kevin,
    Your insurance policy is based on the date of loss. That date is forever recorded and your insurance was in force on that date. You had a total loss so you cannot have a total loss again until it’s rebuilt again. The decision you made seems very reasonable and I would have done the same thing.

  2271. June 18th, 2016 at 9:46 am #Kevin

    Thanks, Jason.

  2272. June 26th, 2016 at 3:44 am #Amy O'Sullivan

    My mobile home, in Point Roberts, Wa burned 2/06/2016. Insurance is Allstate.
    I was in Hospital with Bell’s Palsy at the time and still recovering from that.
    Point Roberts requires me to remove all debris and it is all classified as toxic waste. It must be put in bins that run $3,500 each 3-4 are estimated to be needed and removed by the Transfer Station in PR. It has to go through Canada and back into the United States. Total costs will run from $15,000 to 30,000.
    Financial ruin for me… at 73. I thought I had a full coverage homeowner’s policy, but not only was I not informed of these laws that require special ways of removal, additional coverage was not offered, I would have been glad to pay a higher price for coverage. Did Allstate have a responsibility to tell me that their $2500.00 allowance would not be adequate to meet Point Roberts debris removal criteria? I have no knowledge of where to start. There have been several much smaller issues in trying to work with them, but this is the big deal one. Any information or advice to share? Please!

  2273. June 27th, 2016 at 8:22 pm #Jason

    Amy,
    You and current readers need to understand allstate (and farmers) are one of the top two insurance companies not to enter into an insurance contract with.

    Insurance doesn’t cover everything, and the things it does cover can have limitations. Mobile homes have a lot of limitations and exclusions. Even full coverage policies have exclusions and limitations.

    No insurance company has an obligation to tell you anything. However, they do put it in writing what your exclusions and limitations to coverage are in your policy declarations and actual insurance policy.

  2274. June 29th, 2016 at 2:27 am #clare

    Hi

    I have recently had a leak under my floor from my radiator pipe which when discovered it wasn’t a continuous leak it was more like a split in the pipe sprinkle leak this has been going on for some time and has rotted my floor boards and even my joyce , its spread to almost 6 foot of my entire living room and basically ruined my carpet and settee. My carpet is mouldly and also the corner piece section of my couch has has mould on the back leather bit due to the carpet being wet etc

    I have made a claim against my contents insurer to replace my carpet and settee. The third party has came out and looked at my settee and basically said in the report that the settee can be professionally cleaned and inserts can be replaced because these do smell of must and mould an rusted brackets can be replaced also. surely if these are replaced because of the damage caused to the leak then surely the leather is damaged too and they have to replace my suite?

    Do you have any advice ?

  2275. June 29th, 2016 at 12:33 pm #Kell

    Hello admin iam currently with MetLife homeowners insurance. Recently my house was broken into and electronics cloths and jewelry was stolen. Its been 3 weeks and although my claims adjuster seems very friendly with me I question her pace at resolution my claim. She told me that she was waiting on a police report in order to resolve my claims. What I wanted to know was that after I submitted proof of ownership and a inventory list is she able to give me a dollar amount verbally before she receives the police report. Here in Baltimore county md it’s takes weeks to receive the report

  2276. June 30th, 2016 at 12:47 pm #nicole

    we had a rain/wind/hail storm june 15th damaged the roof, and siding caused a power outage/surge which in return caused the sumpumps we have 2 to go out having 7 inches of water enter the house and caused damage to the air compressor to the outdoor air unit. My question is would this fall under one claim I have a policy that also has a water backup included.

  2277. July 2nd, 2016 at 5:38 am #Jason

    Nicole,
    I don’t know. I can’t even determine how many policies you have. You have one that has water backup and another that doesn’t? How did water enter your home?

    Your explaining 7 inches of water in your home and then say that caused exterior water damage to the air unit outside. Did interior water really cause damage to the exterior air unit? If not, what cause that unit’s damage?

  2278. July 2nd, 2016 at 6:08 am #Jason

    Kell,
    A dollar amount is jumping the gun. First coverage has to be determined. When you said the things taken included clothing, I said who would take clothing, especially used clothing, except for the person who owned (and was familiar) with it? Don’t look for a dollar amount before coverage has or has not been determined.

  2279. July 2nd, 2016 at 6:11 am #Jason

    Clare,
    You just said the leather is damaged but have not demonstrated it is. Replacing something not damaged makes no sense.

  2280. July 8th, 2016 at 8:24 am #Melissa

    I had a water heater break causing damage to my home. The insurance adjuster came out, assessed the damage, and issued a decision. The check was not written to the mortgage company, but was written directly to me. I took the lead, hired a company, and had all the restoration and repair work completed, per the insurance adjusters report. This was 8 months ago. Now my mortgage holder wants to come in and inspect the repairs. Do I have to allow them to do so when they were not involved with the claim or repairs prior to this?

  2281. July 9th, 2016 at 8:59 am #Jason

    Melissa,
    Probably not, but your issue is not insurance related. It involved your agreement you have established with your mortgage holder and you. Your insurance company is not part of that agreement.

  2282. July 14th, 2016 at 7:49 am #JB

    We had storm damage to our roof in May, due to delay with insurance due to amount of claims due to this storm, and mortgage bank holding insurance check, it has not yet been fixed. We now have a leak that has gone thru and damaged the inside of our garage due to a hole in the roof. We found this yesterday after another rainstorm. Our insurance Co is saying this is new claim and subject to new deductible. Is that correct? The damage had initially been done in May and due to slow response, the repair was delayed. The bank had the check since 7/1 and we have yet to get the $.

  2283. July 14th, 2016 at 7:59 am #JB

    We had storm damange to hour home in Missouri in May. Due to delay with insurance, due to large amount of claims , and now the morgage bank holding our check, repairs have been delayed. They have included complete roof replacement in this claim bioth the adjuster and contaxtor insepected the roof in mid June..
    We now discovered a roof leak that has damaged our garge ceiling due to a rain storm yesterday. The Insurance co. is stating that this is new incident, subject to new deductible. We don’t agree. We have filed all paperwork timely with the insurance co. and the bank. The bank has had the check since 7/1 and as of yesterday it had not yet been issued to us. Do we have any hope in getting this newly discovered damage covered?

  2284. July 17th, 2016 at 8:14 am #Jason

    JB,
    You may have filed the paperwork timely but you failed to timely make the temporary repairs or permanent repairs so you would not have more damage.

    Your new damage will probably be covered but it is certain to be a new and separate claim from your storm damage, with another deductible.

  2285. July 17th, 2016 at 1:01 pm #Kati

    I currently live at my moms house temporarily. We had a storm hit on Wednesday and lightening was believed to strike and ultimately knock over a massive oak tree. This beautiful tree fell and totaled my mom’s camper and my 6 month old car. I have filed a claim with my auto insurance company but, (I will be the poster child for GAP insurance in the future) I do not have GAP insurance and can guarantee there will be more owed on my new car then I will get from my insurance. Should her home owners insurance cover the difference in this? If they won’t cover it could my renters insurance cover it? Of coarse when people need to use their insurance it’s for typically tragic situations and of coarse they don’t make these already difficult situations any easier.

  2286. July 18th, 2016 at 5:54 pm #Jason

    Kati,
    No, you can only use your automobile insurance for your automobile. You can’t use your apartment or your mother’s home insurance for your automobile.

  2287. August 2nd, 2016 at 11:36 am #Jsam

    A toilet on my 2nd floor was stopped up and overflowed to the 1st level through my kitchen and dining room ceilings and walls. My kitchen cabinets and counter tops were wet but show no visual warping. However, 8 weeks later our insurance company has only offered a fraction of what it would cost to fix the damage so no work has been done (no cleaning either). Despite many emails and voicemail messages, I rarely get a response and now they are saying they want to try to clean, not replace all of the carpets, cabinets or counters. Maybe 7 weeks ago I would have considered that but 8 weeks later? They are taking a pretty hard stance on these items. Am I being unreasonable in being very concerned about bacteria and cross-contamination? I suffer from an autoimmune disease and I am currently undergoing chemo treatments. It was considered category 3 water damage and the insurance Co said we must follow the IICRC guidelines. I’ve read them and they seem to recommend replacement of any items that were wet from this water but now the Ins Co wants to ignore the guideline and when I bring that up they don’t respond? Not all the carpets were soaked but water has been tracked from room to room during this whole process.

    Thanks – JSam

  2288. August 18th, 2016 at 5:47 pm #Jim Pinkerton

    My mom has ALFA homeowners insurance in Alabama; I’m not sure which type of policy. But a licensed mold inspector has recently told us the home is uninhabitable due to mold, and that if the health department checked the home it would be condemned. I know ALFA says mold isn’t covered, although they replaced our duct work from the HVAC unit throughout the home 2 years ago due to mold because the adjuster said previous water intrusion from a tree that hit our home could have caused the mold in the system because the duct work inside the attic was not flush with the duct work coming into the house from the HVAC unit, there was an open gap. He said if we went to court the court would probably side with the homeowner anyway since it couldn’t be proved either way what caused the mold in the duct work. But this is the whole home the mold inspector is referring to now. He said it is basically like a fire, a total loss due to mold. My question is if the mold isn’t covered, does ALFA homeowners insurance still have to cover our motel, or other lodging, etc., expenses while we have the home completely mold remediated and fixed since the mold is an uncovered cause for us to need immediate relocation and lodging? Thanks for your assistance!

    Jim Pinkerton

  2289. August 19th, 2016 at 7:38 pm #Jason

    Jim,
    What triggers additional living costs is a covered cost of loss. If mold is not covered, then additional living costs would not be reimbursable.

  2290. August 23rd, 2016 at 1:04 pm #J. Lynne

    Jason, I don’t know if you have an answer, but I’m hoping you can give me some advice. I have a client who had a major fire in December of 2014. My company was hired to perform the restoration, which has taken a REALLY long time. They changed the framing causing architectural delays, upgraded everything, weather delays, etc. Long story short, we are at the final stages of completion and need additional funds to wrap it up, but the insurance company (Allstate) now says that they no longer owe for recoverable depreciation or supplemental items as it has been over a year since the date of loss. We had been keeping the adjuster in the loop, however, he left the company without notice at some point. The new adjuster just told our clients that they don’t have to pay them now. Is there anything we, or our client, can do here? Help and advice will be deeply appreciated.

  2291. August 23rd, 2016 at 6:41 pm #Jason

    J. Lynne,
    An insurance company will pay for the loss of a covered claim at ACV and upon completion of the work within 1 year, they will pay up to the cost of replacement. Since the repairs have not been completed within 1 year, the insurance has no obligation to pay any amount over ACV that they initially paid.

    The insurance company is out of the loop and the repairs you’ve made are now owed to you by the homeowner.

  2292. September 1st, 2016 at 12:15 pm #Tanya

    I live with my elderly mother. Early last month, there was a fire in her house that caused a great deal of damage. The structure seems to be okay, but the inside must be completely redone. We have had contractors submit bids for clean up and repair, but they were $10,000 – $30,000 over her $70,000 of coverage for the structure. I have compiled a list of contents by physically counting as well as from memory for the rooms that were really badly damaged.
    I have the following questions:
    I can only estimate when and where she got some items because she cannot remember. Some things were gifts, I am sure. I have very few receipts and researched the items online for prices and have a good idea where things were bought over the years. My purchase price and replacement are almost all the same. The amount came to over $80,000 for a $35000 contents coverage.
    Questions:
    1. They ask for the purchase price, replacement cost, value prior to loss and value after loss. Are these are required or can I leave the prior and after values off? How would you account for gifts? Estimate where it came from and estimate the cost or indicate it was a gift and no cost was incurred obtaining it?
    2. I used the form the gave us to complete the inventory as a guide for an excel spreadsheet. Can I scan her signature on each page so she doesn’t have to actually sign all of the 150+ sheets of items or does each sheet require her actual signature? We discussed it this morning and she is not looking forward to writing for that long with arthritis, as you can imagine.
    3. My name is on the deed for the property, but not the mortgage or the insurance policy. The paperwork asks, “List others with interest in the property”. I know her mortgage company would be listed. Do we have to list my name as well? (I am not interested in being listed on any checks or agreements.)
    4. My step brother has been calling the adjuster and contractors without my mother’s consent. There has been a strained relationship for years and now he has gladly ‘volunteered’ to seemingly help us. How do we legally stop him from interfering and causing issues with her claim? Can he cause issues for her since she has not given him permission to communicate with the insurance company?
    5. With the total expenses for contents is more than double the coverage amount, what is the likelihood that she will get the max for her contents?

    Sorry this is so long, but with dealing with this every night, working more than full time, on top of losing our home has been overwhelming. I appreciate any help and answers you can offer. Thanks so much!!!

  2293. September 1st, 2016 at 8:02 pm #Jason

    Tanya,
    1. Provide the replacement cost as what you can find it for, and the current after loss value as $0. Your value prior to the loss should be the replacement cost of the item less the amount of depreciation of the item. Nobody keeps receipts. Who cares if it’s a gift? Your insurance doesn’t matter how she acquired the stuff.

    Use a spreadsheet and have her sign the last page. Who cares that each sheet they provided has a signature area on it?

    3. Your ownership interest in the property, let’s say it’s 50%, will reduce your mother’s insurable interest in the property by 50% since you are not an insured under the policy and you apparently don’t have any insurance for your interest in the property. This encompasses into the legal aspect of the claim and I don’t provide legal information on this site.

    4. Have your mother communicate with the adjuster that no one, except her and those she has previously authorized should be allowed to discuss any aspect of her claim.

    5. I don’t know enough about the loss to give any information about what may be paid for the loss.

  2294. September 6th, 2016 at 12:55 pm #Michelle Curtis

    Hello, four weeks ago today I being paid as caretaker watching a 90 year old woman in her home and tripped on the homemade wheelchair ramp that was built at the front door falling fracturing my hand and wrist which required surgery last Thursday. The plan was to have me replace her current caregiver which was delayed by my up coming surgery though I did work filling in a few days until my surgery. With that income I would of been able to pay for my medical costs. Apparently the lady had a change of condition and they will no longer require my services and that means I have no income and I’m already behind with these current medical costs. After explaining this, the daughter in law is dragging her heals filing a claim though she was informed of my injury and my plan of care. Is there a way I can find the name of her home owners insurance and do so myself or should I obtain an attorney and let them handle it all moving forward?

  2295. September 6th, 2016 at 2:23 pm #Jason

    Michelle,
    Based on how your injury happened, and absence of any liability of the homeowner, you were injured on a wheelchair ramp you had used in the past and were aware of its condition and layout. Most homeowner policies have medical payments available for injuries you sustain while on the property of someone else. This coverage would also apply to “resident employees”.

    Normally this medical payment coverage is $1000 -$5000. Obtain the insurance company name from the daughter-in-law so you can file a medical payment claim under the homeowner policy. I see no benefit of hiring an attorney but that is a decision you have to make yourself.

  2296. September 6th, 2016 at 5:45 pm #Are Home Insurance Claims Taxable Income | The Home Insurance

    […] Home Insurance Claims Advice – FREE … – Post Home Insurance Claims Advice and Help Question (below) Or, get answers at your finger tips (including personal consultation and confidence building … Posted on September 6, 2016Author admin […]

  2297. September 16th, 2016 at 10:24 am #Kenna

    The hose to one of our upstairs bathrooms cracked and flooded our entire house almost a year ago. By the time we had returned home there was water pouring out of light fixtures downstairs there were puddles about 2 inches high on all the floors downstairs. We made an insurance claim and they ‘fixed’ everything or so we thought. We have two children a 4 month old son and an almost two year old daughter, since the incident my daughter has had a lot of upper respiratory infections and my son at 2 months old was hospitalized for 2 weeks do to an infection and high fever and they could not figure out a reason as to why he was sick. So since all of this I’ve had reasons to believe there is mold in the house and I’ve said it since day 1. They pulled all the carpet up and stuck dehydrators under neath it and replaced only the padding. We have recently pulled out the cabinets in the kitchen and found mold behind them, and our kids are still havi. Issues so I’m assuming the carpet does also. Is there a way to make them come back and fix everything they previously didn’t? We had to pay a huge deductible for this the first time around is there anyway around a deductible this time? Thank you.

  2298. September 16th, 2016 at 5:56 pm #Jason

    Kenna,
    There are a couple of issues at play here. Your insurance company covered your loss by paying you to have a contractor repair/clean your house appropriately. Which party failed in their obligation? First, you had the loss, you reported it, and you paid your deductible. You, as the homeowner, hired a company or companies to repair/clean your home. Then, the repair/cleaning was completed and it all should have been completed to a pre-loss condition. Lastly, your insurance company paid for the repairs/cleaning because of your insurance contract.

    Everything in that chain of events was done fully and appropriately by everyone involved with the exception of the contractor you hired. If a contractor doesn’t do the job correctly, the remedy for them is to do it again, but this time they need to do it correctly.

    Does your insurance company need to pay for the job again because the contractor failed to do it correctly the first time? Absolutely not. You should not even bother your insurance company at this time.

    Should you have to pay another deductible and have health problems with your family? No.

    Should the contractor be required to come back into your home and repair/clean your property appropriately as they were already paid to do? Yes.

    Now, let me be clear. Your concern is not with your insurance company. They did everything required of them. You did everything required of you. The party that failed you is the contractor. They were paid for a service that they did not yet deliver. Your issue is with the repair/cleaning contractor. They were already paid. They now need to repair/clean what they were already paid to do. Your concern is not insurance related – it’s contractor related.

  2299. September 16th, 2016 at 7:52 pm #Same

    I have a very,very big issue for the last 2 years. My husband and I own a home in MA. In a neighborhood that is very closely knitted, where houses are practically touching each other.
    On October 2014 , we were about a week away from selling our house. We had already 90% moved out. We had close on our purchase about a month ahead of time. The closing was supposed to be back to back but the buyer had some delays in getting funds from her 401k, which pushed our sale off for a couple weeks. With no reason to believe that we weren’t going to sell our current home, we went ahead and closed on our new place, lender being aware that we were selling and that it would not be a financial risk for them to lend is money to buy a property.
    A week before our scheduled closing date a retaining wall collapse into our yard and slammed into the back of our house, causing the wall to cave in, destroying out kitchen and our second floor room. The retaining wall has been determined that it belongs to the neighbors behind us. Our house is sort of on an incline and the neighbors behind us are looking down on our property. Needless to say, we were not able to proceed with the sale.
    We filed a claim with our homeowners insurance company. They sent an adjuster and an engineer out to investigate. Are claim was then denied due to “earth movement” which is not covered in our policy. We live in MA. No expectations that we would need earthquake or earth movement coverage. Can they just broadly deny us like this? The collapse of the wall caused damage to our home. It has now been deemed uninhabitable by the city. We are not able to make any remediation of the concrete retaining wall and repair our property. Shouldn’t they still be obligated to still pay for the house damage?
    So, the other part of the story is: we discovered that our neighbors behind us had paved their driveway and did not obtain a permi, did not have any kind of runoff for water. We don’t know how long the wall had been there. City has no record either. The current owners however has been continuously covering up cracks in the the driveway and then paving it over, unsafe that they were contributing to the deterioration of the wall and ultimate collapse. We have filed a third party claim against their insurance company. They are working with us but they refuse to pay for the replacement wall, only the cleanups and restoration of our house. They had their own engineer come out to figure out what needed to be done and how to make it “safe”. The report was a joke. I’m not an engineer but I’m pretty sure that reusing collapse and broken concrete would not be considered and using sandbags to prevent further erosion is a “make safe” plan. So they are not fully accounting the cost of the work it would take to clean, remediate and restore our property back to its pre-wall collapse.
    To make matters worse, because we had bought another house, the fire we have another mortgage, we were only able to continue with the mortgage payment for a month or two. We reached out to our lender and seemed their help, legally, financially, anything, but they refused any assistance. They haven’t even started foreclosure proceedings because at this point, the property has no value. they don’t want it. Now we are coming up on almost 2 years. They are demanding to get paid. They are aware that an offer of settlement is out there and they want to get paid, in full. They basically want to paid off, and as it stands right now, we would only have roughly 18k left to remediate and repair what is potentially a 180k project. And a property with no value.
    Oh…did I mention that not only did we get denied coverage from our insurance company, they also cancelled our policy due to”abandonment”. Obviously the house is unsafe and unlivable as deemed by the city.

    We are working with an attorney who thinks that if we don’t settle soon and payoff the mortgage, the lender will sue us. So, it just keeps getting better! Everyone keeps telling us that this is a unique situation. And it requires time and research. We don’t have time or the funds to pay attorney’s fees to continue to research!

    1st question: should we go back to our insurance company and fight with them on the basis of the denial?

    2nd: can we force the neighbors insurance to pay us enough that we can pay off the mortgage and make repairs to the property and put it back to before the collapse of the wall. Because their insured was negligent and contributed to the collapse, should their insurance company be made to pay and make us ‘whole” (pre-collapse of wall)?

    What more can we do? We can’t afford to continue negotiating but we can’t afford to NOT continue negotiating.

    Can you point out avenue that we could possibly explore? I’m stressed, financially strapped and damaged and about to lose my mind over this.

    HELP!

  2300. September 17th, 2016 at 8:45 am #Jason

    Same,
    You have an attorney. Ask your questions to your attorney. I won’t get in the middle of you and someone you are paying money to provide you with assistance and legal help.

  2301. September 17th, 2016 at 2:19 pm #Does Home Insurance Cover Roof | easy home insurance

    […] Home Insurance Claims Advice – FREE … – Post Home Insurance Claims Advice and Help Question (below) Or, get answers at your finger tips (including personal consultation and confidence building … […]

  2302. September 18th, 2016 at 5:46 am #Darren

    I have to replace a bathtub in my rental property because the old one is scratched up. If I remove the tub and see that the framing on the bathroom wall needs to be replaced because of moisture, will my insurance cover that?

  2303. September 18th, 2016 at 6:23 am #Jason

    Darren,
    There seems to be more to your situation than what you’ve indicated. Why would you think your structural framing has been wet for such a long time that it would need to be replaced? Regardless, the policy covering your rental unit is likely a DP-3 and the following language is included in your policy which likely addresses the condition you referenced.

    2. We do not insure, however, for loss:
    a. Excluded under General Exclusions;
    c. Caused by:
    (7) Constant or repeated seepage or leak-
    age of water or steam over a period of
    weeks, months or years from within a
    plumbing, heating, air conditioning or
    automatic fire protective sprinkler sys-
    tem or from within a household appli-
    ance.
    (8) Any of the following:
    (a) Wear and tear, marring, deteriora-
    tion;

  2304. September 19th, 2016 at 6:42 am #Michael

    How long would it take for a investigation? I was hit as a pedestrian walking a cross walk on 7/29/16 started claim on 8/19/16. I wasn’t hurt past some minor soft injury’s and want to move forward to cover my hospital bills. Ive called and asked information and more so e-mailed I was told last week they would have more information for me that week but nothing and today im told there investigating further.

    Am I getting the run around? What should I do this all seemed pretty straight forward

  2305. September 19th, 2016 at 6:13 pm #Jason

    Michael,
    It can take a couple of days, weeks, months, or years – depending on the nature of the investigation. You were hit as a pedestrian and your injuries were not severe, but apparently required some medical treatment. The investigation should be closer to a couple of days to a week for your situation. Keep calling or inquiring so you can get your claim resolved.

  2306. October 27th, 2016 at 8:58 am #Nate

    Hi,

    My wife and I just had a house fire that was started by a lightning strike, our home was considered a 95% loss. We have asked about replacing the foundation and basement floor but we’re told the fire didn’t damage them so they won’t cover it. I don’t want a brand new home on a possible bad, leaking foundation.

    The fire department pumped in almost 40k gallons of water to stop the fire and the basement was under 3′ of water until the clean up crew came in.

    We also have a 20% additional insurance clause on our home. Is it league and would it be in our best interest to have the foundation repaired?

    Also if the insurance doesn’t want to replace the foundation can I hire an outside building inspector to at least look at the foundation and home to make sure they replace everything that needs to be replaced?

    Any advice would be great.

    Thanks,

    Nate

  2307. October 27th, 2016 at 4:53 pm #Jason

    Nate,
    You can do anything you want to the foundation since you are the owner. You indicated you were told the foundation was not damaged. If it is not damaged, why would you want your insurance to replace it? Your insurance company only addresses covered items that are damaged.

    It’s your home, you can hire anybody you want.

  2308. October 30th, 2016 at 11:06 am #Jonathan

    A fired occurred in an adjacent condo to mine almost two years ago. It reached my place and caused the front windows to implode, fire damaged a good area in the living room and smoke and water were thruout the place.
    My State Farm claims rep. had, at the time just after the fire, went with me through the unit and I did receive a replacement cost benefits report.
    We as owners decided a year ago that the place would be torn down and new units built which is almost complete.
    I called my claims rep. a month before the building was to be torn down and he came again to do a final check before it did.
    I had $54,00.00 in total coverage for the unit (additional coverage for contents) and now that I’m using the work sheet he provided I see that it covers areas in the living room and kitchen that were damaged but I don’t see anything to replace the fixtures that were in the bedrooms and bathroom that were heavily smoke damaged and asbestos was found in the unit as well.
    I spoke to my rep. and he said that would not be covered and that the approx. 25K he determined that loss would be would be the total I could recover.
    Part of my argument is that if he did consider my steel appliances as a loss due to the smoke which can etch into the steel and can’t be removed why couldn’t I be reimbursed for such items as my bathroom fixtures, light sconces, and all metal work that would never have come clean.
    All along in the early stages when he gave me a check a year and a half ago he said that the reason he wanted to give it to me is because Colorado law required insurance companies must make payments as losses are assessed so it doesn’t appear that they’re unfolding unfairly payments.
    If I would have know prior to the demolition of the building that those items wouldn’t have been covered I would have entered the unit, at my own risk, and salvaged what I could and stored it.
    Do I have a case for the remaining 30K and if so would it be best to have a lawyer draw up for me a letter outlining the facts for the request?
    Of course his conversation telling me via cell phone to not worry about this then was recorded and I went on good faith.

    thanks,

  2309. October 30th, 2016 at 1:17 pm #Jason

    Jonathan,
    Ask the adjuster to include the items you want covered. Provide him good reasons why those items should be covered. You can clearly write so why would you need to hire an attorney to do something you are more than capable of doing yourself?

  2310. October 31st, 2016 at 11:31 am #Larry

    My house sustained damage during hurricane Matthew and I can’t afford to make the repairs with my salary. I believe my mortgage company has insured the home to cover their losses but not mine. I received a call from the mortgage company requesting my mortgage payment. I cannot afford to pay the mortgage and make the repairs. What should or can I do?

  2311. October 31st, 2016 at 6:15 pm #Jason

    Larry,
    The way you submit the information, you are in, or near, foreclosure. There is nothing you can do about the storm damage based on your inability to pay for the damage and your limited salary. The home seems to be headed toward bank ownership. Look for a new place to live.

  2312. October 31st, 2016 at 9:03 pm #chet

    I had some roof damage due to hail. I called the insurance company and the allowed for half of he roof to be replaced. I did not want to do the repairs due to he discoloration of the old roof figuring in Oklahoma there would be another storm. the money is being held in my saving account. my question is what options do I have to change insurance companies. I do not want to deceive a new insurance company and wonder if the “current” insurance company would still be liable for the cost of one half of the roof. will a new insurance company even consider taking me on as a customer or will I have to get the damaged roof repaired first.

  2313. November 1st, 2016 at 4:51 am #val

    I had a company approach us and told us we had hail damage to our roof and siding.We live in the Chicago area. An adjuster came out and we got approved for the roof and siding.That company wanted us to do the roofing and siding with them. However after discussing the siding with someone we know who is a contractor we decided that we would have him do the work in the following spring as he said that proper installation would require a warmer temperature. However the roofing company is asking us if they should submit the completion for the roof as well as siding to the insurance. I like to keep the money for now instead of returning it and then go thru the hassle of asking for the the money again in the spring. Can I do that ?

  2314. November 1st, 2016 at 5:47 pm #Jason

    chet,
    You can switch to a new company if you want. They may ask if you have preexisting damage and that is where you would indicate you do. You are not misleading anybody by getting a different insurance company.

  2315. November 1st, 2016 at 5:52 pm #Jason

    val,
    Hire the contractor you want since you are the property owner. Just because a contractor pointed out your damage does not obligate you to use them. You don’t have to return any money to the insurance company.

  2316. November 2nd, 2016 at 5:00 pm #In Need of Advice

    Hi Jason,

    I appreciate you taking time out of your day to provide insight on this forum. I realize your feedback may or may not be something I agree with or want to hear, but I see the value in it either way.

    My wife and I own a home in California that recently flooded due to a pipe bursting under the house. Some important background info, we bought the home as a short sale property. At the time we bought it, there were renters in the home. After the purchase, the renters kept asking to extend their rent. This went on for about 2 years until we finally moved in.

    No more than 2 months after we moved in, we woke up one morning to the sound of water running. I ran downstairs to check up on it and found several inches of water covering the entire first floor of the house.

    Being new homeowners with no experience, we decided to go with a public adjuster that was recommended to us. Our adjuster handled the entire claim and started by contracting a company to come in and dry out the floors and walls.

    Once the drying process was finished, our adjuster started the claim process and claimed the entire kitchen and all of the flooring. Our insurance company took a VERY long time to respond and finally approved the kitchen and the downstairs flooring. They denied the laminate on the stairs and upstairs even though we went as far as to geet a signed document from a flooring expert stating it was impossible to match the flooring.

    After the drying process, we noticed there was a chip in the tile area next to the front door so our adjuster started a claim on that as well. We had a tile expert come out and estimate the repairs to be approximately $1500, which we claimed. Our insurance company responded saying they would send someone out to take a look at the damage (I assume it was to decide whether it would be something they would cover). Not long after, they changed their mind and sent us an EUO notice instead. (Note: we had not been able to claim our food expenses yet. It is my understanding that everything is on hold and I am not sure how this part of the claim is going to be handled following the EUO).

    My wife and I figured we have nothing to hide since everything we claimed is legitimate, so we agreed to go. We contemplated hiring an attorney but the amount in question does not justify it, so we decided to go without one.

    The EUO date is in a couple days and we are starting to worry whether we made the right decision. We welcome any advice you may have for us.

  2317. November 2nd, 2016 at 6:55 pm #Jason

    In need,
    You have a public adjuster that you hired regarding your claim. Perhaps your questions should be directed to him. He knows way more than I do about your situation.

    If your public adjuster can’t or won’t help you, you may want to consult with an attorney.

  2318. November 14th, 2016 at 8:15 am #Bryan

    We live in NC and have State Farm for our home owners policy. In our kitchen area we have a section of the back of the house that cantilevers out over the basement wall. Thus is is more exposed to the elements and was under insulated. Possibly as a result of the under insulation we had 2 very cold days (-10 with wind chill and 0 degrees air temp at night and warming to almost 30 day time) and midway through the 2nd day as it warmed up we heard several popping noises in the kitchen. as a result we have a huge section of tile that needs to be replaced. Is there something in the policy that would allow coverage for this freeze / thaw effect on the tile? initial estimates to repair range from $2,000 to $4,000 depending on how many tiles can be salvaged and how many adjacent tiles end up needing replaces as a result of the under-layment sheets needing to come up too.
    Appreciate any feedback. Agent didn’t think it was covered, but I realize they work for the company I’m asking to pay for it….

  2319. November 14th, 2016 at 4:40 pm #Jason

    Bran,
    It seems you agent may be onto something. Your policy contains this exclusionary wording and it may apply to the situation you described:

    B. We do not insure for loss to property described in Coverages A and B caused by any of the following. However, any ensuing loss to property described in Coverages A and B not precluded by any other provision in this policy is covered.
    b. Design, specifications, workmanship, repair, construction, renovation, remodeling, grading, compaction;

    The “ensuing loss” may be the freezing of your flooring which is part of the exception to the exclusion noted above. Is freezing of floors covered under your policy?

    Freezing seems to apply to some limited elements of your house relating to water, but not the flooring or subflooring. This is the policy language I’ve reviewed:

    14. Freezing
    a. This peril means freezing of a plumbing, heating, air conditioning or automatic fire protective sprinkler system or of a household appliance…

  2320. November 18th, 2016 at 3:39 pm #Larry

    We had a sudden leak from under our kitchen sink and it damaged the floor and we have just discovered that it has damage the subfloor under the kitchen cabinets on one side of the kitchen. the adjuster tells me that if the cabinets need to be replace, my policy will cover that, but they won’t pay to replace the cabinets or countertops on the other side of the kitchen.

    Which means that we have mismatching countertops and cabinets on each side of the kitchen, or we have to come out of pocket to pay for half of the cabinets and countertops.

    Does that seem right? I would think that the policy would pay to replace both sides so that they match.

  2321. November 18th, 2016 at 5:55 pm #Jason

    Larry,
    Your insurance provides for direct damage that is sudden and accidental. Your cabinets on one side of your kitchen were damaged by an incident that was sudden and accidental.

    The cabinets on the other side of your kitchen were not damaged. Those undamaged cabinets were not damaged, let alone damaged by a cause that was sudden and accidental.

    Your policy does not provide matching coverage protection. Matching is not considered damage.

  2322. November 21st, 2016 at 7:37 am #Ann

    In late July I discovered what was determined to be a leaking supply pipe in a common wall of my condo. My insurance agent encouraged me to file a claim which I did and even though I have a replacement policy the check (which I still have not cashed) was far below what the original estimate came in at.

    I thoroughly researched my CCR’s and found a clause indicating the HOA was responsible for common elements and even after pointing it out to the adjuster was told that they do not subrogate and the battle was up to me to fight. Luckily I have a friend who is an attorney who stepped in and eventually got the HOA to agree to cover the damages directly since the master deductible was more than the damages.

    I spent hours and hours of my own time researching and arguing with the HOA and insurance company, was without a working kitchen for several weeks, and was so stressed out I became physically ill. I missed work during this period and underwent costly medical tests to out rule a serious condition. Thankfully I’m fine but my question is, do I have to return the check or is it mine to keep?

  2323. November 21st, 2016 at 10:56 am #Gene

    I filled a home insurance claim in 2014 for hail damage to my roof and house. My insurance company issued a check for approximately $21k for roof and paint, which was made payable to me and the mortgage company. We never cashed the checks because my mortgage company started an illegal foreclosure on us so we counter-sued for the illegal foreclosure. It took over a year to resolve the matter and we ended up agreeing to a settlement where we owed nothing on the house and the house was later sold by our mortgage company. We had informed our insurance company of the lawsuit shortly after receiving the checks, so they placed stop payment on the checks until we directed them what to do once the matter was resolved. We have been contacted regarding the checks now and are wondering whether we can have the checks issued to us? It appears the new homeowner bought the house as is and made all the repairs. I was told my insurance costs have increased because of the claim regardless of whether we cashed the check or not. Can we get the check issued directly to us and if so, how?

  2324. November 21st, 2016 at 5:23 pm #Jason

    Ann,
    You can do anything you want with the check you received. Instead of using it to repair the damage, you had found another means to get the damage repaired. When an insurance company sends their insured money, the money doesn’t have to be returned.

  2325. November 21st, 2016 at 5:28 pm #Jason

    Gene,
    Talk to your adjuster and get the check sent back to you. I don’t care if it’s to you, or you and the mortgage holder. Since the mortgage holder has no further interest in the mortgage, they should willingly endorse the check.

  2326. December 11th, 2016 at 5:06 pm #Brina

    We had damage from H. Matthew. The adjuster said we needed a new roof because there were a couple of tabs scored by a branch and because it was 12 years old (30 year shingles). We had a roofer (the same one who did it 12 years ago) look at it and he said the roof is fine but recommended replacing the ridge vent because there have been problems with it “in the past”. He repeated several times that he wouldn’t replace the roof. We’re thinking not too many people would cut themselves out of work. They paid us to replace the fence, however, we have found out that we will lose 4 foot of our yard due to newer local laws regarding replacement so our only option will be to repair part of it, instead. Also, the adjuster said we needed to replace garage door, garage door opener, flashing, gutter, front storm door, pergola, and an outdoor shed. The problem is that their check, after deductible and depreciation will not cover most of it; a new roof will take most of it. We can fix part of the fence ourselves to keep that cost and loss of space down, but whatever is left is minimal. We don’t have that kind of money in savings to do the rest! The check was written out to us and our home lender. They signed the check and sent it back with a letter telling us to send them stuff (the insurance adjusters report [which does not add up with the insurance company letter], showing the repairs/replacements have been done. We don’t know if we are lawfully required to show our lender this/these documents. We don’t know what to do or say to anyone! We have called our insurance to get clarification on (A) & (B) losses as well as personal losses (C) but none of his figures add up. Please advise. It seems the clock is ticking, companies are not showing up for estimates or even answering calls, and we still don’t have accurate papers of estimates for our insurance adjusters Help!

  2327. December 12th, 2016 at 3:26 am #Jason

    Brina,
    Do you have an insurance related question or questions?

  2328. December 14th, 2016 at 2:22 pm #Heather

    We live in Indiana and had a hot water pipe bust under the slab in October. The insurance covers the kitchen cabinets, counter top, kitchen flooring and the wood floors in both the living room and family room. Insurance company (QBE) cut a check in our name and “Chase”. Total was for $25,000 and was deposited on November 14 in escrow, and said we had to get a licensed contractor to do the work. Indiana does not require a licensed contractor or any permits to install kitchen cabinets or the flooring. We told the insurance Co and chase that we were going to do the work ourselves since we have hung cabinets before and it was my husband and I that installed the wood floors when we bought this house that are now destroyed. Insurance Co said they didn’t care who did the work, Chase had us fill out and write a letter stating we would be doing the work ourselves and then they would deposit the first $10,000 to start the work. It is now December 13th and as of today Chase stated to my husband and myself that they do not let the homeowners act as there own general contractor. I asked if there was a written contract we signed stating this. Chase replied “no” and stated they would not release funds until we had a signed contract with the licensed contractor and then they would cut a check in both of our and the contractors name. We have had this mortgage for 16 years and we just want to be able to do this ourselves and use the money that would go to a needless contractor, for upgrades. No where in our policy does it state that a licensed contractor must complete the work.
    Can Chase do this legally if no contract exists between Chase and us the homeowners requiring a licensed general contractor?

  2329. December 14th, 2016 at 2:30 pm #Jason

    Heather,
    Sure, your claim is to insurance. Your insurance has paid and done what they are contracted with you to do. Your concern is with your mortgage holder. Unless you signed a contract w/your mortgage holder that indicates your repairs will be completed by a licensed contractor, you only need to follow repair building codes in your state. I don’t like to get involved in non-insurance issues, but it appears your mortgage holder is being too controlling.

  2330. December 17th, 2016 at 1:52 am #Kat

    My husband and I live in northeastern TN and during a bad snowstorm 2 years ago snow apparently blew in through the roof ridge vents and then melted causing water damage to a couple of areas of our ceiling. One had actual water dripping but the others just left water marks. We did not have roof damage. This was a rare event as we have snow/wind in our area during the winter and never had this happen before. We elected not to contact our insurance at the time as we felt with our deductible not worth doing so. We have noticed a few other spots since then that we just didn’t see initially – not new damage and not as much and are wondering if we can still file a claim or if its too late due to the time that has passed. We have not had another storm since then like that or any water issues since then. Thanks so much!

  2331. December 17th, 2016 at 10:41 am #Jason

    Kat,
    You would have to make a claim to determine if your insurance would cover the condition of your ceilings, including the stains.

    Your delay in reporting the claim may be a barrier for you though. An excerpt from a standard homeowner policy, which will be similar or identical to your policy, is provided below:

    B. Duties After Loss
    In case of a loss to covered property, we have no
    duty to provide coverage under this policy if the
    failure to comply with the following duties is prejudicial
    to us. These duties must be performed either by you, an “insured” seeking coverage, or a representative of either:
    1. Give prompt notice to us or our agent;

  2332. December 21st, 2016 at 8:01 am #Paul

    Admin,
    I accidentally backed my car into my garage door. The damaged garage door needed to be replaced and, because my original doors (I have 2 garage doors) we so old (no matching doors are currently available), I had to replace both my garage doors (no homeowners would want non-matching garage doors!). My insurance is only prepared to cover the 1 damaged door. Shouldn’t both be covered? Does this depend on a “set clause” or “pair clause”? I heard that there was a law passed recently to protect homeowners on matching garage doors… is this true? Any/all advise would be greatly appreciated!
    Thanks,
    Paul

  2333. December 21st, 2016 at 5:07 pm #Jason

    Paul,
    You heard from who or what source that there was a law passed that protected homeowners concerning matching garage doors? That assertion sounds a bit made up.

    Anyway, your homeowner policy provides coverage for direct and accidental damage. The overhead door you backed into was damaged in a direct and accidental way. That door should have been replaced and paid for by insurance.

    Your other door was not damaged as far as I can tell. You took it upon yourself as the owner to replace the undamaged door. That is your choice because owners can do whatever they want with their property.

    There is no coverage in your homeowner policy for matching. For example, if your garage door was white and a bit faded, and you replaced it with a new door, the other door would match just fine. The existing door may have some oxidation on it (slightly faded) but your new door will oxidize over time too. There is absolutely no law regarding matching of anything on. or within, a home. There has been case law relating to matching items on or within a home that has developed based on lawsuits and rulings – but in your case, and the undamaged garage door you replaced doesn’t pertain to those rulings.

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  2335. January 12th, 2017 at 7:46 am #Lisbeth

    We live in CT and 3 months ago, in early October 2016, our furnace malfunctioned while we were away for a few days. When we returned home late at night, our entire house was like a sauna with water dripping from nearly every ceiling, wall, and window. We immediately called the oil company since they had just replaced parts on the furnace (3 weeks prior) after we had a power surge which knocked out some electronics in the house. The technician who came by was in shock at what was happening and said that they’d have to send the technician who had replaced the parts out the next day. In the meantime, we got the ball rolling with calling the insurance company and they sent out a restoration company within a few hours. The owner tested the walls for water levels and he developed his plan to start drying the house out. However, some mold was already forming on some windows and they told us that they’d have to clean it first to remove the mold so the spores wouldn’t fly through the house when the machines started running. In the meantime, a textile company came in and removed all clothing/sheets/curtains/etc. We were literally left with the clothes on our back and what we had taken with us to Boston. It was all such a whirlwind and I was in shock at what kept walking out of our house when there wasn’t really the need for everything. But since we never experienced this before, we assumed the experts knew what they were doing. At the same time, the oil company technician was sent to the house to replace the damaged parts and LEAVE them as they would be inspected. Our insurance field adjuster wasn’t planning to come to the house until day 5 or 6. But after much insistence from my husband, the adjuster did come (day 2) He originally was only going to have the basement ceiling removed. Again we pushed for the entire basement to be gutted since that was ground zero. Much of the playroom was destroyed and in the unfinished parts of the basement, my husbands tools were rusting out in addition to most of the pipes and oil tanks.

    After the house was dried out for 3-4 days, we had a hygienist test for mold. Our adjuster had warned us that that wouldn’t be covered since we only have a $5,000 mold cap. However, any mold would be directly related to this incident. So after testing, the hygienist found high levels of mold in the entire basement and half of the first floor of our house. His recommendation was to gut all of that since it was invisible and could be hiding in the walls/floors/etc. He recommended getting rid of all pourous materials. Our adjuster had emailed the restoration company to give an estimate on that demolition. This is where the communication stopped. We never heard back from the adjuster and he wouldn’t respond to our inquiries. One other adjuster filling in for the desk adjuster admonished my husband that the mold isn’t covered and that condensation doesn’t cause mold and we’d have to pay for anything mold related.

    In the meantime, the mold was growing back on the same surfaces before the “cleaning” from the restoration company and now in some new areas that were not properly dried. At that point, we hired a public adjuster to help us. At first, they were very assertive, claiming that they’d be able to get a lot of this covered. We let them do their thing and assess the house. They weren’t too successful in getting a meeting set up with the insurance field adjuster who is busy with large loss claims. It took several tries and about a month. They finally met 5 weeks ago (2 months after date of loss) Much more damage has continued to surface at the house. Kitchen cabinets bubbling, more trim work and baseboards pulling away from the walls, among other things. The field adjuster was supposed to get back an adjusted estimate (he called in contractor and electrician) 3 weeks ago and still…nothing. So right now, all we have is a gutted playroom portion of the basement. The insurance company refused to gut other parts, saying they weren’t bad enough despite the hygienists recommendations with high levels of mold.

    We have been disappointed with the lack of communication with us by the public adjuster we hired. We had a meeting with them on Monday and the owner was very obnoxious and unprofessional. We wanted to show them what has happened even since their meeting 5 weeks ago. He was very short with us and said he didn’t wan’t to lose credibility with the field adjuster. Mind you, he previously boasted about all the things he does on behalf of the homeowner with this particular field adjuster. However, I think they have another larger claim with this field adjuster and we believe that he doesn’t want to make a lot out of our major loss so he can gain more from the bigger major loss. Again, they have not responded to emails from us this week. We NEVER got a print out of the scope of damage with an estimate from them. They just kept telling us that they were asking for lots more. I did call a reference they furnished us with and although the couple got a lot more than they would have if on their own, they did admit that they had to be on top of this company because of the lack of communication. I just learned this week that they never submitted to the insurance company all of our ALE receipts and cost of living spreadsheets that we submitted to them over a month ago. My fear is that it makes us look non compliant in the eyes of the insurance company.

    Apparently, the furnace pieces didn’t show any sign of problems (we are still waiting for the public adjuster to give us that report) so it could be that the technician messed up with the installation. How do you prove that? All I know is that we have 4 kids whom we homeschool, our lives have been turned upside down, we are tired of camping out, and it looks like we are at a dead end. What would you suggest? Should we call the state insurance commission, the CEO of Safeco Insurance, and/or a lawyer? We are really at a loss of what to do at this point. By the way, the public adjuster never gave us back their signed portion of our agreement 2 1/2 months ago. We don’t know who to trust anymore!

    Thanks so much for any advice you can offer us.

  2336. January 12th, 2017 at 7:08 pm #Jason

    Lisbeth,
    From the information you provided, I don’t know if the resulting condition of your home is from a covered cause of loss.

    Based on the language of a standard home owner insurance policy, which is likely what you have, the following policy language raises concerns whether or not your loss is a covered event:

    B. We do not insure for loss to property described in
    Coverages A and B caused by any of the follow-
    ing. However, any ensuing loss to property de-
    scribed in Coverages A and B not precluded by
    any other provision in this policy is covered.
    3. Faulty, inadequate or defective:
    b. Design, specifications, workmanship, re-
    pair, …;
    c. Materials used in repair, …; or
    d. Maintenance;

    (The first part of the exclusion language above indicates your policy won’t cover your furnace (or its service) for the enumerated actions that are excluded. Resulting damage, even though the event or item causing the damage is excluded, may be covered.) Based on your policy, your loss must be sudden and accidental. Although a furnace malfunction may be accidental, the continued production of heat is not sudden. It occurs over time. In your case, the time duration was days. The continued elevation of heat in your home didn’t cause damage – the differential between your home’s interior and the home’s exterior caused an extreme imbalance of temperature that led to higher moisture levels inside your home. The elevated moisture is not sudden and goes back to a sudden and accidental covered event which is required for coverage.

    Since you indicated the furnace service was 3 weeks before you were absent from your home for a few days, none of the work, parts, or maintenance may even come into consideration pertaining to your loss.

    Even the Limited Mold and Fungus coverage provided by your policy requires a covered cause of loss to prior to becoming effective as a coverage. In addition, your additional living expense requires a covered cause of loss for that coverage to become available to you.

    Your first thing is to determine if your home’s condition is from a covered cause of loss under your policy. That seems to have been skipped even though you’ve had action and activity from your insurance company suggesting coverage despite what I interpret may be a non-covered loss.

    You’ve hired a public adjuster. You are paying him to assist you with your claim. If you need any guidance, get that from your public adjuster, not me. I don’t want to step on your hired representative’s toes.

  2337. January 16th, 2017 at 5:32 am #Ellie

    Hi, we had a downpour of sewage from a blocked upstairs toilet (our only one) causing a flood up to about one inch deep in the kitchen below. The flooring is lino. The cupboards and sink and draining board were splashed with this foul stuff and have not yet been cleaned several days later. We have mopped to clear the floor and the insurance company have put us up in a hotel, sent in people to clear the blockage and want to send people to fit new lino in the kitchen and clean the cupboards. I am worried the cupboards are now contaminated and need replacing rather than just cleaning. Should I accept the offer to “deep clean” or push for replacement cupboards? Any advice would be very welcome. Thank you.

  2338. January 17th, 2017 at 3:25 am #Jason

    Ellie,
    It’s grey water contamination. There is an industry standard for addressing that type of water damage. You should do more research about what should be done in your case since I don’t know the details of your claim and don’t know exactly what should be done to your home.

  2339. January 17th, 2017 at 4:00 pm #AJ

    Hello

    First of all, this is v helpful discussion board and thank you for all your help.
    My house got completely burned down. My insurance company concluded, after getting their engineer at the site, that the house can be rebuilt and had an estimate according to the rebuilding and replacement cost. Our whole claim is $220 K but their estimate is $169k. And they even introduced me to their contractor who would be doing the job of repair and rebuild with in their estimate amount. I got my contractor and he says that it’s a total loss and he can’t rebuild it, it has to be demolished. I even got my city code officer and he put a condemnation notice on my house. So do you think I have enough ground and proof to fight back to get my full claim of $220 K ? After getting the notice what do I need to tell the adjuster?
    Thanks

  2340. January 17th, 2017 at 4:42 pm #Bill

    Hello,

    We had a dishwasher leak damaging HW floors that run throughout the first floor. Also the Cabinets on either side of the dishwasher were damaged. Our Insurance co sent us a check to cover 1600 sq ft of flooring and the replacement of several cabinets. Great!

    1590 sq ft of flooring are near perfect and seems a waste to rip them up. We have a box of leftover wood and a few salvaged pieces our contractor says he can weave in seamlessly. Can we do this. The idea is to repair the flooring and instead of replacing those two cabinets. Just use the floor money to replace all of the cabinets? Basically repair the damage and get a new kitchen instead of two new cabinets stuck in with the old. Can we do this? We have a mortgage so the bank actually has the check. Does the bank care HOW I fix it. Does it need to match the adjusters report?

    Thanks!

  2341. January 17th, 2017 at 5:31 pm #Jason

    AJ,
    It’s your home and you can hire anyone, or not hire anyone, you want. That goes for their contractor. If you don’t hire that contractor, your home can’t be repaired for the amount they’ve indicated.

    Get your contractor directly involved with your claim so he can offer some persuasion that the home is a total loss.

    Each state has addresses what is called the valued policy law. Look up the information pertaining to the state in which you live to see if that law applies to your situation.

  2342. January 17th, 2017 at 5:47 pm #Jason

    Bill,
    It’s your home and property. You can repair it anyway you want. You don’t even have to repair it if you don’t want to.

    Your relationship with your bank is different. They are using your home to secure the loan. Talk with them about your plans. They should be fine with what you propose.

  2343. February 1st, 2017 at 10:24 am #Meghan

    Hello,

    We live in a condo which has 4 units. We had a water heater leak and the water seeped into my neighboring unit (who is the association president) causing water damage in both units.
    The association asked us to work with the master insurance company. We submitted quotes to the insurance company and got the repairs done only after they asked us to go ahead. The estimates were never submitted to the association as they never asked for the same.
    We received a check ~3 months after the claim was opened which is 10% of the total repair estimate we had submitted but my neighbors repair costs were all paid out. When we contacted the adjuster he said the claim had already been settled with the association.
    We were never consulted or notified by the association (president) about the settlement. They sent us a check weeks after the claim had been settled and we were never made aware of what was going on between the association and the insurance company in those 3 months.
    Is the association president required to contact the unit owner before settling the claim with the insurance company? DO they have full authority to settle the claim without talking to us or asking us for repair estimates? Also, they had received estimates from the adjuster 2 months ago and never shared the same with us.
    As a unit owner, what are my rights? We have scheduled a meeting with all the unit owner later this month.

    Thank you

  2344. February 1st, 2017 at 5:34 pm #Jason

    Meghan,
    The association president is not required to contact anybody regarding his settlement with his insurance company. Yes, the insurance company can settle the claim in any manner they see fit, and you don’t need to consult with them before hand.

    If you want to discuss unit owner rights, you should discuss that with an attorney.

    Your scheduled meeting sounds like a waste of time.

  2345. February 28th, 2017 at 11:33 am #John

    Last October I incurred water damage in my garage from a neighbor’s water leak above my garage. He notified his insurance company and said they would take care of the problem. The insurance company hired a water restoration company to fix the damage. The work lasted nearly a month to complete. It should have taken no longer than a week to complete including the water drying process as there was only minimal drywall demo and repair. A month later I received a check from the insurance company for my loss. There was no itemization of the settlement and I assumed the amount included money for loss of use of my garage which was approximately one month. 4 months later I received a bill from the water restoration company requesting payment for their work. The amount was excessive and was almost as much as the the insurance payment. Do I have legal recourse as I did not hire the restoration company the neighbor’s insurance did.

    Thank you

  2346. February 28th, 2017 at 7:52 pm #Jason

    John,
    Make a claim with your insurance company and submit the information you have to support your claim. I don’t know if you hired that company, why they billed you, and what the check amount represents.

    If they did work to your property, you technically hiref them since only the property owner can hire work performed to their property.

  2347. March 5th, 2017 at 2:09 pm #Yuval Nir

    Estimated replacement cost questions:
    House fire. Total loss claim. How is ERC calculated for item models that no longer exist such as:
    1. A 3-6 yr old cell phone or camera, a 40 yr old high end film camera, a 40 yr old high end classic guitar etc.
    2. What to do when the adjuster changes the ARC to a level far below the item quality and value?
    3. A year after an item is submitted, The item model might not be available or the market price may vary significantly. What then?
    Thanks.

  2348. March 5th, 2017 at 2:29 pm #Jason

    Yuval,
    1. With similarly available items that are new.

    2. Bring the issue up to him and support, with examples, why the item allowance should be adjusted.

    3. Get the next closest available item. The price won’t vary significantly. In fact, prices of items predominantly goes down, not up. For example, a 70 inch flat screen tv has gone down in price over a short period of time.

  2349. March 7th, 2017 at 5:30 pm #Yuval Nir

    Thanks. Also, the adjuster is declining photo restoration after I submitted a quote, I paid for.

  2350. March 7th, 2017 at 6:41 pm #Jason

    Yuval,
    I would hope he would not consider reimbursing you for a quote you paid for concerning photo restoration. Photo restoration is a vague and undefined process to an inherently personalized item. Your adjuster has more knowledge of your claim than I do so I will have to defer to him and assume he’s made the correct declination.

  2351. April 1st, 2017 at 4:15 pm #JaneE

    When O&P is included in RCV and noted on the insurance adjuster’s breakdown, should a sub-contractor deduct that from their bill.

    I had my roof replaced along with painting and gutter work on an insurance claim. They show the O&P for each job along with ACV and depreciation. My understanding is that the O&P is included in the total of RCV. Shouldn’t any sub-contractor take that into consideration (especially the roofer) when billing their cost of the repair.

    The way it has worked out for me is that I come up with a shortfall because the roofer billed the RCV total. Doesn’t seem right.

    Thanks,
    JaneE

  2352. April 1st, 2017 at 4:54 pm #Jason

    Jane E,
    The total line items for painting, roofing, and gutter is what the contractor should bill for.

    O&P is a separate line item which is earned and payable to the general contractor.

  2353. April 3rd, 2017 at 3:30 pm #JaneE

    Thank you Jason.

    I am awaiting response from my insurance adjuster to confirm what I believe to be an error on the roofer’s billing regarding the O&P before I open that can of worms.

    The contract shows a total that includes the O&P and I am hopeful that they agree that this was in error and will adjust their bill accordingly.

    Is there a standard practice that I can point them to that will support this?

    Best,
    JaneE

  2354. April 3rd, 2017 at 5:35 pm #Jason

    JaneE,
    Who is the general contractor? They have more of a vested interest than the insurance adjuster does. The general contractor pays the subcontractor. The general contractor should be paid the proceeds of the claim. What the roofer bills has nothing to do with you or your insurance adjuster.

    This situation is so wrong that I don’t even know why we are discussing it. If your roofer is submitting a bill, that is wrong. He should be submitting that bill to the general contractor and the general should be submitting the bill. The only one submitting bills should be the general contractor. Ignore any bills unless submitted by the general contractor.

    Have your insurance adjuster write the checks out to you and the general contractor only. Again, we should not even be talking about the roofer’s bill.

  2355. April 3rd, 2017 at 5:58 pm #JaneE

    Sorry, Jason. I didn’t mean for you to react this way.

    Perhaps I haven’t been clear enough.

    Initially, there was a general contractor in the very early stages of this claim. Due to communication issues and many delays in not scheduling when the final claim was approved I voided our contract. I had made a deposit at the beginning of these negotiations, which was two months in the making, to refine the adjusters numbers . The GC had not pulled a permit nor had he ordered supplies. This made me very apprehensive (I knew the funds had been spent since he had requested additional funds) and I paid him for his time and efforts and took the job on myself. I was able to get a refund on my initial deposit. So I became the GC at that point.

    That’s why I am receiving bills and paying them. That is why I am involved in this query. I want to make sure I am doing the right thing and in my research I have read that a policy holder can be the GC and receive the O&P for performing in that capacity. Am I correct or not?

    Thanks again for your help.

  2356. April 4th, 2017 at 3:33 am #Jason

    JaneE,
    When I have only part of the information, I cannot give complete answers.

    Pay your contractor what you owe him and nothing more. You are in total control of that, not his bill.

    You can be the general contractor but you need to actually be the general contractor, perform as that role, and have your insurance adjuster recognize you in that capacity for them to pay you the overhead/profit.

    Some insurance companies recognize their insured as a general contractor and some don’t. (An insured is not supposed to profit from their damage so why would an insurance company pay their insured “profit”. Further, and insured has no general contractor overhead, so does that expense need to be paid to an insured with no overhead?)

  2357. April 5th, 2017 at 4:41 pm #James

    We had water damage at our home so the insurance company sent out a restoration company. After they had done their work the insurance company denied the claim and we ended up having to pay the restoration company even though we wouldn’t have had them come out if we knew it wasn’t covered by the insurance company that sent them to our home. No one told me it might be my bill or even suggested it. When I called my agent he agreed that it hadn’t been explained correctly by him, the insurance company or the restoration company because it’s a really confusing situation and so he was sorry.
    However, the more I think about it the more angry I get and I feel like I was taken advantage of by no one talking to me about us possibly paying that bill IF the claim was denied. I assumed they could deny the claim but I didn’t know that meant they wouldn’t pay for a company THEY sent to my home and who immediately started working without so much as a conversation with me.
    Someone mentioned to me that this sounds like an E&O situation. What do you think?
    Thanks for any help or advice!

  2358. April 5th, 2017 at 6:02 pm #Yuval Nir

    What are house content items not subjected to depreciation and how to confront the insurance about it?

  2359. April 6th, 2017 at 3:14 am #JaneE

    Well, it’s all moot at this point Jason.

    I am dealing with a reputable roofer. They acknowledged that they were in error and we settled for the amount that I had paid the former GC, $600 less than what they had over billed. I was not looking to make a profit, just break even.

    Everyone’s happy.

    Thanks again,
    JaneE

  2360. April 6th, 2017 at 7:03 pm #Jason

    James,
    The someone who told you your situation sounds like an E&O concern is mistaken.

    It’s very likely that someone from the restoration company spoke to you before they began their restoration efforts in your home. How did they gain entry into your home to perform the work if they didn’t speak to you? It’s very likely you signed a contract with the restoration company as well. The only person who can hire a company to do work to their home is the homeowner.

    Your home seemed to have needed the attention of a restoration company. If it did not, you wouldn’t have had them in there. If a claim is denied by your insurance company, you are responsible for any contractor you hire. Had there been coverage for your damage, the bill would still have been yours – the only difference is the insurance would have paid your bill for you.

  2361. April 6th, 2017 at 7:10 pm #Jason

    Yuval,
    I am not aware of anything that doesn’t depreciate. Your homeowner policy should have replacement coverage for personal property so replace the damaged items and the depreciation applied will be meaningless since you are replacing the damaged items with new items.

  2362. April 7th, 2017 at 1:20 pm #James

    Hey Jason,

    I understand what you’re saying and that’s pretty much what the adjuster told me too and I understand that now. The reason they were let into the house is because my agent told me that since we weren’t staying at the house at the time and it was needing immediate attention to leave the door unlocked for them so yes, we did ultimately give permission for them to enter. I’m more frustrated with my agent and the information he gave me prior to me ever speaking to the claims adjuster. I took what he told me about how claims work as fact and then when I spoke to the adjuster she told me that agents shouldn’t be telling clients how their claim will be handled because each case is different and they aren’t in claims. That’s why I called my agent to complain and he said he was sorry that he explained it wrong and that he made the mistake of telling me that whether they approved the claim or not that the initial restoration company would be paid for by the company since they sent them out. He even said that now he’s learned something! As you know, and as I’ve found out since then, that is absolutely not the case so the agent never should have told me that. I think that’s why I was told it could be a possible E&O claim against the agent, not the adjuster or company and definitely not toward the restoration company.
    I appreciate your response and I guess if anything, I’ve learned a very valuable (and expensive) lesson. I will be switching agents for sure.

    Thank you,
    James

  2363. April 7th, 2017 at 4:35 pm #Jason

    James,
    Insurance agents sell insurance. Claim adjusters settle claims based on coverage or lack of coverage. You wouldn’t make retirement investment decisions after consulting with a mcdonald’s employee so why would you hold information from your insurance sales agent about a non-covered loss as fact? I can’t believe you didn’t talk to your adjuster before your agent told you what he did. How did your agent know the restoration company was going to be working on your home before the adjuster discussed your claim with you?

    Whether or not the agent told you anything, you should not rely on information from anybody that is contrary to the language in your contract (policy) with your insurance company. If a claim is denied, it is fully denied, not partially. Your policy outlines that fact very well.

    Here is what a typical Errors and Omission’s policy covers:
    -Alleged or actual negligence
    Claims alleging negligence from professional services including failing in “duty of care”, giving incorrect advice or making mistakes.
    -Defense costs
    -Personal injury (e.g., libel or slander)
    -Copyright infringement
    -Temporary staff and independent contractors
    -Claims arising from services provided in the past
    -Claims and damages

    Let’s assume the agent was negligent for telling you the claim will be paid by your insurance company even though non-covered damage and ultimately a denied claim is not paid by your insurance company. We will further assume the E&O insurance accepts liability on behalf of the agent in your favor.

    The next step is to determine damages. As a result of your agent telling you incorrect information, what damages did you sustain relating to the information you relied upon by the agent? The damages are $0.00. When all is said and done, you had water damage and you hired and paid for a company to dry/repair the water damage and you were billed for their services to restore water damage – damages your agent didn’t cause.

    Is the invoice from the restoration company damages? No, it is charge for restoration services to dry, protect, and repair your water damage. In all reality, getting the water damage addressed immediately likely saved additional and lingering water damage that was not covered by your policy.

    If after you read this information and you want to attempt to make an E&O claim, that is a decision you will have to make on your own.

  2364. April 7th, 2017 at 8:26 pm #Yuval Nir

    No Answer?
    What are house content items not subjected to depreciation and how to confront the insurance about it?

  2365. April 8th, 2017 at 6:31 am #Jason

    Yuval,
    Your response can be found in post #2362. I still can’t think of anything that doesn’t depreciate.

  2366. April 9th, 2017 at 3:31 pm #Yuval Nir

    Thanks so much.

  2367. April 10th, 2017 at 11:08 am #James

    Jason,

    I appreciate your response and I understand exactly what you’re saying. I do want to clarify a couple of things though. I didn’t speak with anyone from the restoration company personally but my agent told me that since I wasn’t staying there (since it happened to be on Christmas Eve) to leave my door unlocked and the restoration company would go right in and start the work. So, in that case, yes, I did give them permission to enter my home and do the work. I’m not upset with the restoration company because I don’t feel like they did anything except their job and what they were told to do.

    The reason I mentioned an E&O Claim is because of the information I was given directly from my agent. When I called to report that we had a pipe burst he said that the insurance company would send out a restoration company and then when the insurance company assigned an adjuster and was able to look at the claim, etc. that’s when they would decide if it was a covered loss or not. I asked about the bill from the restoration company and asked if we would have to pay that bill if the company decided it wasn’t a covered loss. My agent told me that even if it wasn’t covered, meaning to have it fixed, that they would still take care of the expense from the restoration company because they were the ones “hiring” them and because the company wouldn’t want any other damage to happen to the dwelling. I realize now that sounds ridiculous but unfortunately I took what he was saying as fact, since I had never dealt with anything like this before.

    Once I actually spoke with the Claim’s adjustor and she explained how it works on their end, it made complete sense. I explained to her what my agent had said and she told me that in no way should the agent be giving clients advice or telling them that something would be covered on a claim because they are not trained in that area and are told not to give that type of advice out. When I called my agent back and told him how upset I was and that he had given me completely false information, his response was “I’m sorry that I was wrong. I’ve thought that’s how it works all along so now I’ve learned something new too. I’ll quit telling my clients that the restoration company that is first sent out is covered by the insurance company, no matter what.”

    So, that’s where my frustration came in and why I wanted to know if an E&O claim against the agent was a possibility. Like I said earlier, I’m not mad at the restoration company or at the claims adjuster. She explained everything very well and very detailed, I just cannot believe the agent is that oblivious to claims and that he’s giving responses to clients that are sounding very factual and then has the response of “I have been telling people that since I started, I guess I’ve learned something from this too” makes me furious!

    If anything I guess I’ve learned an important, and expensive, lesson from all of this and I will definitely be switching agents as soon as possible. I want an agent that will tell me the truth and if they don’t know how claims work, that’s fine, just tell me so. Don’t lead me to believe something just because you’re wanting to be the “nice guy” during it all.

    Hopefully now you understand more where I was coming from. I really appreciate this webpage and think it’s great. I also appreciate your response to me in such a timely manner. If for any reason, if anything I’ve said here makes you think differently about my situation and that I may have any options, please let me know. If not, thank you for your time and have a great day!

    James

  2368. April 10th, 2017 at 11:11 am #James

    I’m sorry Jason, I didn’t realize my comment had posted yesterday so I was going to tell you the story again and realized not only had my last comment posted but you have responded also.

    Please ignore my last LONG post!

    Thank you!

  2369. April 10th, 2017 at 11:19 am #James

    Hey Jason,

    After reading your response, it makes complete sense and it was completely my bad for assuming the agent knew anything about claims. Thank you for not only explaining it to me but going into detail to where I completely understand it now. I will still switch agents, but now I don’t have an attitude towards them for what happened.
    At least the bill was small enough I was able to pay it and I will always be aware of how much of the responsibility falls on me to know the details rather than just assuming my agent does.

    Thanks Jason, I really do appreciate your time!

    James

  2370. June 26th, 2017 at 1:04 pm #Marie

    My town house received moderate water damage through the wall from neighbors flooding toilet.
    Their flooding happened while I was away on a 6 month business assignment out of state.
    I had to fly back home on emergency flight 2 days later to allow the remediation company in to place drying equipment in my home. It’s been 3 weeks and i’m still here as I have very expensive art and sculptures and don’t want to leave a key.
    I’m using my vacation time to watch my place.
    Someone else temporarily took my place on the business assignment.
    Can I be reimbursed by her insurance company for emergency airfare, excess electric use for 10 days of fans and dehumidifiers, as well as my food expenses?
    Thank you,
    FlyHome

  2371. June 26th, 2017 at 6:30 pm #Jason

    Marie,
    From what you’ve indicated, I can’t determine if your neighbor was negligent. If your neighbor is not negligent for your water damage, her insurance would not consider your water damage, travel expenses, electricity usage, or any food.

    You may want to discuss your expenses with your insurance company.

  2372. July 15th, 2017 at 2:33 am #Arthur Dunn

    I had a young man back into my out door handrail. he broke the concret step. also bent the vinal and steel railing. my quistion is that the insurance company wants to reuse the bent and broken parts. is this alowwed. thank you. Arthur

  2373. July 16th, 2017 at 8:23 pm #Jason

    Arthur,
    If repairing something is reasonable, then it is allowed. You should really consider filing a claim with your homeowner insurance since your coverage through your homeowner policy provides more coverage than the liability coverage you would have through the driver’s insurance.

  2374. September 19th, 2017 at 7:19 pm #verna gattone

    I filed a claim with Safeco for a roof collapse from the snow. the agent put it as wind damage. Safeco gave the ok to start repairs but then they stopped. never told me but told the contractor. I have a hole in my roof and rain is getting in since the contractor stopped the work…who is responsible for the damage inside my house?

  2375. September 20th, 2017 at 5:36 am #Jason

    verna,
    You are responsible for any damage to your property. Your insurance company doesn’t repair your roof, or stop or start the work. That can only be done or authorized by you. Your insurance company only pays, or reimburses you for the covered damage.

    Your contractor works for you, not the insurance company so any direction he follows should be from you.

  2376. October 19th, 2017 at 1:51 pm #Amerie

    Please please help me. I am a single mom. We have been out of our house since May. My public adjuster is slimy and charging me 20 % on a main fire in NJ. He has one of his people do all the grunt work and only jumps in when I educate myself, which I did not in the beginning, because he talked a good game. I believe he is committing fraud. He OWNS the mitigation company HE sent to my house, who did not do a good job of cleaning up to begin with. Doesn’t he have to tell me he has a financial interest in the mitigation company? He never told me. I found out on my own. I also saw their estimate of work and it was so inflated and untrue and when I confronted them about it, they said “it doesn’t matter, the insurance company didn’t pay that amount anyway” It does matter because you are taking money from me and putting it in YOUR pocket I am struggling so bad and I don’t have enough money to do my house because the PA took it all. SO in NJ is it a law to a.) provide me with a scope of work and b.) tell me that you own/have a financial interest in the company that YOU sent to do the mitigation work? he is making all the money and I am suffering and so are my kids. I hired him to work for me Not himself. Please help me. I need to maximize my claim and get my house fixed and get back home. I wish I did my research about him.

  2377. October 20th, 2017 at 4:59 pm #Jason

    Amerie,
    Your marital and parental status have nothing to do with insurance. Ownership of a company doesn’t have to be disclosed to anyone. (A wise thing would be for the person hiring someone to review references and recommendations.)

    I don’t think it is a requirement anywhere for a PA to tell you the scope, but I don’t know all the details of the contract you signed with him. I would defer to the PA contract you signed.

    Nobody is required to tell you about a financial interest in anything. You, however, should selectively hire your contractors. You willingly hired him to work for you at the rate of 20% of your claim amount, while settling to do 100% of your repairs for 80% of the insurance payment amount.

    You don’t need to maximize your claim amount, but your PA has every incentive to do that. You initially start out with the claim amount of 100%. By hiring the PA, you adjust that to 80%. That isn’t close to maximizing your claim.

    You should have done your research about your PA. I address insurance questions between a consumer and the insurance company. Your concerns are between a PA and you. You appear to have no insurance questions between the insurance company and you.

  2378. October 20th, 2017 at 6:12 pm #Amerie

    Well Jason, I was a shaky mess the night my house caught on fire and signed a contract while I was in a state of shock at 2am. By the time I did my own research, it was too late (72 hours) to get out of the contract. No need to be so harsh. I admitted that I should’ve done the reaseach prior to. I am now educated. Relax. I now know a mitigation company and have another PA helping me behind the scenes. He sent the companies to do the clean up. It’s his company I found out and I know for a fact in the state of PA you have to disclose that you have a financial interest in the company so I was wondering the same about NJ. So you are wrong about no one having to tell you about their financial interest. Thanks for your “help” I’m just going to go to the insurance commissioner and the attorney general. Clearly, he’s committing fraud. I just wanted someone else to help with the laws. Again, clearly, I came to the wrong place. I just want my house back to how it was before. Thanks for you sympathetic response.

  2379. October 20th, 2017 at 8:18 pm #Jason

    Amerie,
    So you chose another PA. I don’t address concerns of an insured about 1 public adjuster, but now you are asking me to respond with another PA in the picture?

    Since your concerns don’t seem to matter to the insurance commissioner or the attorney general, I don’t know how they will respond to your inquiry

    It seems you made a poor PA decision and that is the decision you have to live with.

  2380. November 8th, 2017 at 11:36 am #Pat

    I had water coming from the roof from hurricane Harvey. the inspector said it was from raised flashing and not shingle damage. that is part of standard maintenance and not covered. is this correct? I am hearing other things from others in the city .
    thank you.

  2381. November 8th, 2017 at 6:31 pm #Jason

    Pat,
    Your policy requires there to be damage resulting from a covered event for water damage to be paid by your insurance.

    A raised flashing that allows water to enter into your home is not damage that results in water damage. Instead it is a condition based on construction, remodeling, or building that allows for water to enter into your home. It is a a construction defect not caused by any hurricane damage. A raised flashing should be corrected by a reasonable home owner and does fall under maintenance. (If something isn’t right, correct it so damage doesn’t occur). What other things are you hearing from others in the city – because things and others is really vague and sounds like hearsay from unnamed sources?

  2382. November 17th, 2017 at 12:10 pm #Cpatterson

    I have a friend whose home was destroyed in Ga by a tornado about 11 months ago the home was insured for 208500.00 and had to be removed and rebuilt. The ins adjuster is now saying there was a glitch in the program when figuring the policy replacement value and was figured too high. Now, there is a claim total loss claim on the dwelling and the ins co. doesn’t want to give them the amount in which they were insured. The 208500.00 was dwelling only .This has become a battle. INSIGHT PLEASE!!!!

  2383. November 17th, 2017 at 2:37 pm #Jason

    Cpatterson,
    If you want information about what is going on with your friend and his insurance company, you should talk to your friend.

  2384. November 27th, 2017 at 9:31 pm #donald

    what to expect from home owners insurace when my detached well house burnt to ground from eletrical fault from lightning strike personal property loss around 90k

  2385. November 27th, 2017 at 9:40 pm #donald

    what to expect from home owners insurace when my detached well house burnt to ground from eletrical fault from lightning strike personal property loss around 90k I HAVE 230K INSURANCE

  2386. November 27th, 2017 at 10:38 pm #donald

    what to expect from home owners insurance when my detached well house garage burnt to ground from electrical fault…..MAYBE from lightning strike 8 months ago the garage is used very little except for storage of our personal property we did file a claim when our house was struck by lightning mainly our pool pumps and havcs units personal property loss around 90k I HAVE 230K INSURANCE

  2387. November 27th, 2017 at 10:41 pm #donald

    what to expect from home owners insurance when my detached well house garage burnt to ground from electrical fault…..MAYBE from lightning strike 8 months ago the garage is used very little except for storage of our personal property we did file a claim when our house was struck by lightning mainly our pool pumps and havcs units personal property loss around 90k I HAVE 230K INSURANCE on property loss

  2388. November 27th, 2017 at 10:44 pm #donald

    Here we go if you need to see policy please let me know Uwhat to expect from home owners insurance when my detached well house garage burnt to ground from electrical fault…..MAYBE from lightning strike 8 months ago the garage is used very little except for storage of our personal property we did file a claim when our house was struck by lightning mainly our pool pumps and havcs units personal property loss around 90k I HAVE 230K INSURANCE on property loss

  2389. November 28th, 2017 at 8:41 am #Jason

    Your claim will be processed and then settled accordingly. I don’t know the details of your claim so I can’t provide more specifics.

  2390. December 15th, 2017 at 5:23 pm #KYLE

    Hi,
    I took two weeks to provide a very detailed contents list, over 130 images, receipts, and repair estimates for Pc’s that are salvage. The valuation process was finished Monday, i was told its now at the top mans desk awaiting approval/sign off. I have texted and called my adjusted asking for answers all week as i told them i was going back abroad for dental procedure and wanted to handle this prior. Yestetday I had a text from desk adjuster ” Hey, what is your line of work? Employer? ( from what i have read this is not allowed to be considered in claim or even asked….Then…..well you had a designer suit case Gucci ( receipt given) I said what are you asking? Are you wondering if I had the means to pay for such? Adjuster replied…..So you just like nice things right, Ill say that…” I thought to myself. wow…..Now no answers still and its friday. I am irate ….The Pehswar rugs and this bag were brought up. When you have two trees fall in house and 2″ of water in floor and your not home for 2 weeks post storm…Things do rot and get mildewed and ruined….I keep hearing….Sir. I have sent to my superior and its gone to her superior….We have 200,000 claims and its a process….However.The top man obviously looked at my claim to make mention of the higher ended items….What does this tell you…They have more than enough proof and ownership documentation…This has me irate! Its not like this is a large large claim…82 lines and approximately 45k per valuation. keep in mind they used enservio and the managers there signed off on this without isssue….Also they overly complimented me for my detailed outline and list for contents as well as pics…..They told me ” Sir, all of these pics arent needed…..” I thought well who knows they may be needed at a later date…So its obvious they are needed now…The bag was on wet 1 inch rain water soaked floor for two weeks……along with rugs. What do i do to put fire under them? I have called everyone all the way up to the CEO OF COMPANY AND LEFT VOICE MAILS STILL NOT ONE CALL BACK BUT FROM DESK ADJUSTER WHO WILL NOT TELL ME THE HIGHER UP MANS NAME OR NUMBER/EMAIL. THERE IS SOMETHING I CAN DO I HOPE TO EXPEDITE THIS

  2391. April 9th, 2018 at 10:38 am #Gilda

    We recently had water damage to our summer house. The adjuster came and the insurance company sent us the settlement letter and the check listing my husband and I and the mortgage company, Everhome Mortgage. I called Everhome mortgage and they asked me to endorse and mail the check to them and they will decide how and where they disburse the money and after reading a lot of blogs and reviews I feel it’s going to take a lot of time and effort to get anything from them.
    The repairs have already started and we have the funds to do the work. Is it possible to send the current check back and ask the insurance company to inspect the work and send us all the payment, including the recoverable depreciation, once the repairs are completed?
    I know dealing with the mortgage company is going to cause us a lot of extra work and aggravation and I’d much rather bypass them.
    Thanks.

  2392. April 9th, 2018 at 10:59 am #Jason

    Gilda,
    Usually I don’t get involved with an insured and their bank’s relationship. However, I am aware of the reports, reviews, and feedback of that mortgage holder’s customers. I think your assessment is accurate.

    Contact your insurance company and discuss with them all your options.

    Since it appears you didn’t thoroughly review your mortgage company, I have concerns you may not have reviewed your current insurance company either, but that’s just a guess.

  2393. April 9th, 2018 at 12:05 pm #Sean

    Hi,

    I’m the Sean from #1824. I wrote in as our house was hit by a car causing major damage, and was having issues after repairs were made.

    You’ll never guess, but my house was again hit by a car on Saturday. Just a couple feet to the left of where the first car hit, and this time I’m hoping it will be a total loss and they’ll tear it down as it hit the very corner of the house and shifted it about a foot off the foundation.

    my wife and I feel like we know the routine, but realize how clueless we really are.

    My question is, when do you decide if a lawyer or public adjuster should get involved? Everyone thinks its a good idea, but thousands of dollars to pay out if not needed is my worry.

    Thanks,
    Sean

  2394. April 9th, 2018 at 12:38 pm #Jason

    Sean,
    First, make a claim with your insurance company and see how it progresses.

    What everyone thinks is not what’s important. If they support either a lawyer or a public adjuster and pay for that, I’m sure their suggestion would change.

    In what state is your home located? You can either respond in this forum or directly by using the e-mail address in orange lettering at the top of this page.

  2395. April 9th, 2018 at 1:15 pm #Sean

    Hi Jason,

    We are in Wisconsin.

    Our insurance adjuster is getting in touch with the company (same rep and company as last time) we paid to board up the house to set up a meeting.

    Thanks,
    Sean

  2396. April 11th, 2018 at 10:15 am #Jason

    Sean,
    In Wisconsin, a valued policy law is a statute that requires insurance companies to pay the full value of a policy to the insured in the event of a total loss. Valued policy law does not consider the actual cash value of the insured property at the time of the loss; instead, the law mandates total payment. This applies only to a principle residence in Wisconsin.

    Although I included the above information, it seems a block foundation movement of 1 foot, as you’ve mentioned, would likely be contained to a relatively isolated area, not the entire foundation. I don’t know the details of the damage so my assessment is meaningless.

    If you are interested in a person who may be able to assist you in WI who is neither an attorney, nor a public adjuster, I could provide that person’s contact information to you via e-mail.

  2397. April 11th, 2018 at 10:59 am #Sean

    Hi Jason,

    Thank you so much! I would greatly appreciate that contact info, and you are more than welcome to email that too me.

    Again, thanks for your time and assistance.

    thanks,
    Sean

  2398. April 11th, 2018 at 11:17 am #Jason

    Sean,
    Although you input your e-mail address on this site, I don’t have access to your e-mail. Simply send me a short e-mail to the my e-mail address at the top of this page in orange letter.

  2399. April 16th, 2018 at 4:53 pm #Penelope mcgarry

    My friend had a fire causing total loss to his manufacture on dec 10 2016 while living in his garage no hot water available and useing a porta potty is still waiting for his home to be replaced due to no help from mortgage or insurance companies on how to proceed with multnomah county codes for electric water sewer etc…as my friend was a pow vietnam vet he cannot live like this and does not understand who pays for these inspections and is getting burned on every aspect what or who can help him….example demolition guy got pd 20 thousand to get property ready for new home falsified things on billing like how saying 6 dumpsters left with debris when only 2 were here. Pd 500 per load. I know i was here entire time and helped load them…

  2400. April 16th, 2018 at 5:03 pm #Jason

    Penelope,
    I don’t know what the concern is with insurance. It seems the funds are being provided but if the funds are not being used properly, that doesn’t seem to be related to insurance – but rather to contractors and/or money management.

  2401. April 19th, 2018 at 2:39 am #Jen


    My neighbor's trash can was smoking, he opened it next to trees on his property, they caught fire and damaged my house as well as 4 others. His insurance has denied all our claims stating that there was no fault found on their insured and no cause of the fire was deternined. How do we fight this. It seems like they are seeing what they can get away with. I have homeowner's insurance but don't want to put a claim in unless I have to.
    Help!

  2402. April 19th, 2018 at 6:19 am #Jason

    Jen,
    You don’t fight a denial. Through the investigation, your neighbor has not been found to be negligent for the damage to your house. It appears his actions were reasonable and prudent under the circumstances.

    Had you made a claim to your insurance company right away, they may have been able to become part of the investigation as to the cause and nature of the fire. Your delay to inform them may be prejudicial to your insurance company if they have lost the ability to investigate the fire scene and the fire’s cause. Due to the language in your policy, they have the option not to provide you coverage if what you did or didn’t do was prejudicial to them as found in this part of your policy:

    B. Duties After Loss
    In case of a loss to covered property, we have no duty to provide coverage under this policy if the failure to comply with the following duties is prejudicial to us. These duties must be performed either by you, an “insured” seeking coverage, or a representative of either:
    1. Give prompt notice to us or our agent;

    Your options are beginning to expire. You might want to make a claim immediately and hope your delay to give prompt notice is not relied upon to deny your entire claim.

  2403. April 30th, 2018 at 8:42 am #Paul

    I live in Dallas, Texas. My residence was burglarized and my insurance company does not want to pay the claim. I sent them receipts for items stolen. I do not have receipts for all of the items stolen. Still they do not want to pay the claim. What can I do?

  2404. April 30th, 2018 at 9:03 am #Jason

    Paul,
    Is your claim denied? What are the reasons for the denial? It’s not a requirement to have any receipts.

  2405. August 1st, 2018 at 2:36 pm #Goddess Of All

    I had a tree fall on my house. On the claim, the ACVs are itemized (roof, fense, deck, etc). However, when I add them up, the total does NOT match the Line Item Total at the end. It shorts me over $3500. I cannot find an explanation for this disparity anywhere on the claim. What am I missing?

  2406. August 1st, 2018 at 3:19 pm #Jason

    All,
    Talk to your claim adjuster. You should have 2 columns. One with the replacement cost, one with the ACV, and the depreciation should be the difference. You are more than likely allowed to collect the depreciation when the repairs are complete. If you can collect the depreciation when the repair are complete, it would be recoverable depreciation. Some items, might not be eligible for you to recover the depreciation, but check with your adjuster about that.

  2407. August 2nd, 2018 at 12:38 am #Danielle

    Hi there, we noticed a crack on 2 of our walls, under the beam at the peak of the ceiling. We were urged to file a claim by a family member…in case it was roof/water damage. Otherwise it just looks like typical shifting (we are in the San Antonio tx area). Do my husband called the insurance and they sent someone to take pictures etc. Then a third-party called and set up a time to come look at it and said they will remove the toilets to check for water damage and foundation issues…and put everything back at no charge to us. Is this normal? I’m worried that we will have to pay for this.

  2408. August 2nd, 2018 at 5:35 am #Jason

    Danielle,
    Your family member gave you wrong advice. Yes, this is normal. Damage that is covered needs a cause of loss. (Something that caused the damage like a limb falling on your roof). Without a covered cause of loss, your policy will not pay for any damage. Cracks in your walls are not damage – they are cracks and cracks happen from natural movement and shifts to homes. Your insurance company appears to have found no cause of loss and are making sure by having another set of eyes check with more detail. It’s all part of their investigation to either settle your claim or deny it. They are doing what they should be doing and your insurance company is spending money for a claim that should not have been made. With a claim on your record, your insurance premiums may go up – all because of that family member who gave you wrong advice.

  2409. August 28th, 2018 at 3:10 pm #Dee

    I am wondering how I to submit a supplement to my insurance. Long story short (Water damage claim) I had a contractor that turned out horrible to say the least! After letting them go and completing most of the final repairs myself, I need to know how to write/ask for a supplement. Example: Original estimate was written for one coat of paint on the walls, but it really took two coats. The original was written to replace carpet in the master bedroom closet, and in reality the entire bedroom needs to be replaced in order to match as well as now that the closet carpet is gone the bedroom carpet has started to roll. Any advice would be greatly appreciated.
    Thank you

  2410. August 28th, 2018 at 3:19 pm #Jason

    Dee,
    Send a supplement bill with the itemization of the extra costs to make the repairs. You can hand write the bill and send it in. Let them know it is a final bill and it differed from the original estimate due to being missed on the original estimate. Send them photos to show the work has been fully repaired.

    If you need help, contact your claim adjuster. They may try to talk you out of it but send in a supplement regardles. If they have something in their hands, they have to deal with it. Sometimes just paying might be the easiest thing for them to do.

  2411. August 28th, 2018 at 3:25 pm #Dee

    Thank you, although one more detail… How do I get the supplement to ask for new carpet when I don’t have the carpet yet?

  2412. August 28th, 2018 at 3:38 pm #Jason

    Dee,
    With what you wrote, I’m not convinced you need new carpet – especially if the carpet you want to replace is not damaged.

    Send the supplement bill (or estimate if the work is not complete) and ask for it to be approved so you can get the supplement work completed. Send photos and convince them the carpet needs to be replaced. Sell your claim to them.

  2413. August 28th, 2018 at 3:39 pm #Jason

    Dee,
    With what you wrote, I’m not convinced you need new carpet – especially if the carpet you want to replace is not damaged.

    Send the supplement bill (or estimate if the work is not complete) and ask for it to be approved so you can get the supplement work completed. Send photos and convince them the carpet needs to be replaced. Sell the additional damage to them in a logical, convincing way.

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  2415. September 9th, 2018 at 1:04 pm #Eb

    Well first off, I’d like to really thank the admin, Jason, and others that have spent their time to help others out with their questions. This is a terrific website and comment section for struggling customers to find answers and I really hope I am able to find some help with my question.

    I have a question about an ongoing claim that has been really stressing me our for awhile.

    I had lightening hit my home and it sent a surge through my home. The lightening zapped a TV, alarm clock, and my computer. Unfortunately my computer is not just a regular computer but a custom build gaming PC that I built myself 6 months ago. It was very expensive. After filling out all my insurance forms they sent me a letter and it showed that the majority of the items claimed were limited to a $5,000 limit (Electronic Data Processing Equipment) COMBINED, not each LINE ITEM!! Each part of my computer was bought somewhere different and pieced together from scratch, I spent a lot of time and money building it and was so sad when it wouldn’t turn on and even more in tears when my data could not be read or recovered. Yeah, I NOW know that I should have had my coverage increased since I had a $12,000 computer in my home, but I didn’t know all of this until after God decided to strike it dead. 🙁

    I’m currently with State Farm and was curious if this is accurate. I feel like this is wrong information. They are saying things like my monitor, keyboard, mouse, hard drives, cpu are all EDPE (Electronic Data Processing Equipment)! I just don’t believe I should have to settle for such craziness since they are all physical items. Before any letters I really thought they would pay for a hard professional recovery of my hard drives since they had personal photos,receipts, and other important documents like old taxes. I’m asking for items that are physical items, not data.. Well I would like data too but apparently it will be shot down from looks of it.

    Is this all accurate information? Is there anyway to get around them classifying my items as EDPE (Electronic Data Processing Equipment)

  2416. September 9th, 2018 at 2:12 pm #Jason

    Eb,
    The information you are receiving from state farm is accurate. They provide standard coverage under their basic HO-03 policy for Electronics and Accessories up to $5000, while some company’s standard coverage for this personal property category is a mere $1000.

    You had indicated lost documents and information. Those items appear to be under a different coverage category and are not seemingly under Electronics and Accessories. That coverage is copied below but the wording below may not be the exact wording, or limits, as those found in your homeowner policy:

    b. $1,500 on securities, accounts, deeds,
    evidences of debt, letters of credit, notes
    other than bank notes, manuscripts, per-
    sonal records, passports, tickets and
    stamps. This dollar limit applies to these
    categories regardless of the medium (such
    as paper or computer software) on which
    the material exists.
    This limit includes the cost to research, re-
    place or restore the information from the
    lost or damaged material.

    You should be able to claim the costs of recovery especially since “personal records” is rather vague and this coverage is separate from the Electronics coverage. I like the second paragraph of this coverage since it refers to “research, replace, or restore the information from the lost or damaged material”.

    I know this small coverage amount is trivial compared to your total loss but your insurance company should allow you to keep your damaged computer. There may be components that were not damaged that you may be able to salvage. I don’t know if recovery of any parts is a possibility.

  2417. November 1st, 2018 at 3:44 pm #Carol

    I have State Farm and live in NY. The immense rain the past few months has been making its way into my garage and although the water on the floor is not visible unless it’s raining, there are visible mold circles all over the ceiling. Also, everything in the garage had to be trashed because it was all covered in mold. Some of the family members use this as their main entrance and I believe have been creating a cross contamination issue because I discovered that the clothes in my laundry room were damp and had mold all over them, the refrigerator in my basement had mold on all surfaces, pretty much everything had to go, the holiday decorations and papers in boxes, the bar, the leather gym equipment, anything, and everything had mold or smelled of mold even after cleaning. upstairs, the bedroom and bathroom directly above the garage have a smell with no noticeable mold circles although the occupants of that room have been suffering from severe sneezing, coughing, various nasal conditions, and headaches. Today, a private mold inspector took some air samples. I already sent out some surface tape samples and the results showed 4 different molds. The insurance agent said that if it isn’t from a covered event such as a broken pipe, then it isn’t covered and we do not live in a flood zone and do not have flood insurance. I believe the entire ceiling in the garage should be replaced and that something should be done to change the pitch in the driveway which probably shifted over the years because this didn’t happen for the past 14 years and this past few months is a nightmare. I can’t even leave produce on the counter without it molding. Today cost $675. just for the mold analysis. I’m hoping having professional results will help. Any advice would be greatly appreciated. Thank You!

  2418. November 1st, 2018 at 5:54 pm #Jason

    Carol,
    From what you’ve posted, you should replace whatever is contaminated with mold including ceilings and walls, and change the pitch of your driveway so the condition you explained doesn’t happen any longer.

    You have indicated there was not a covered cause of loss for the presence of mold in your home and your agent has indicated the mold isn’t covered. I agree with that assessment.

  2419. December 16th, 2018 at 2:02 pm #terry bernabe

    house fire claim denied. estimates, photos, and proof of loss filed. can I sell the house without jeopardizing our law suit?

  2420. December 16th, 2018 at 2:06 pm #terry bernabe

    house fire claim denied. estimates, photos, and proof of loss filed, can I sell the property without jeopardizing our law suit?

  2421. December 16th, 2018 at 2:11 pm #terry bernabe

    house fire claim denied. damage estimates, photos, proof of loss filed. can I sell the burned property without jeopardizing our law suit?

  2422. December 16th, 2018 at 2:13 pm #terry bernabe

    sorry it didn’t seem to be posting please forgive

  2423. December 17th, 2018 at 11:05 am #Jason

    terry,
    It’s your property and you can do anything you want with it.

  2424. December 22nd, 2018 at 4:03 pm #Isaac T Chavez

    We had a house fire the fire destroyed most of my snap on tools and tool box I have a detailed list of my purchases from my snap on distributor from the first tool I ever bought till the last my question is since my mom is the homeowner that is insured who does the insurance company make the personal property check out too me or my mother

  2425. December 31st, 2018 at 8:41 am #Sean

    Was headed out of town and had a total loss fire my homeowners wants my on and off again girlfriend who’s not on the policy and not living with me to do a euo she said she would give a statement but wasn’t wasting a day we’re on a off moment now. What should I do?

  2426. January 7th, 2019 at 11:53 am #Trisha

    I hired a tree service to remove a large pine tree which was next to my house. He had to remove the branches before he could cut the tree down. He told me that he became over confident and did not tie a rope around the branch that he was working on. He said he thought it would go straight down. Instead it hit a nub on the tree causing it to deflect toward my house. It landed on my air conditioner destroying it. It cost me $3277 to replace it.

    His insurance company wants to settle for what they say is the actual cash value of the unit which is $2621.60.

    I then asked the insurer if that meant the tree service would be paying the difference and they said no.

    So does this mean I have to pay for his negligence?

  2427. January 27th, 2019 at 2:31 pm #Ty Christensen

    If I stored personal property at my brothers home and he has a house fire with full replacement, is my personal property covered?

  2428. February 8th, 2019 at 2:58 pm #Jason

    Ty,
    If your brother makes claim for your personal property it may be covered by his insurance. The damage to his property will be provided to your brother as part of his claim.

    If you have renters or homeowners insurance yourself, you personal property is covered anywhere in the world.

  2429. February 8th, 2019 at 2:59 pm #Jason

    Ty,
    If your brother makes claim for your personal property it may be covered by his insurance. The coverage to your property will be provided to your brother as if your personal property damage was part of his claim.

    If you have renters or homeowners insurance yourself, you personal property is covered anywhere in the world.

  2430. February 8th, 2019 at 3:14 pm #Jason

    Isaac,
    Snap On has a lifetime warrantly on their tools. I don’t know why you would even consider making a claim for the tools.

    If your mother is the insured on the policy, the claim for the tools would be paid to her.

  2431. February 8th, 2019 at 3:31 pm #Jason

    Sean,
    This is an insurance help site. I don’t know what you can do with your on again, off again girlfriend.

    If your girlfriend was not an insured under your policy, the insurance company cannot compel her to do a EUO. You cannot force her to do something she doesn’t want to do. Neither can the insurance company.

  2432. February 8th, 2019 at 3:38 pm #Jason

    Trisha,
    You can submit your claim to your homeowner insurance. They should pay the full cost of the AC replacement. (You will have to pay your deductible).

    Then when you are paid, your insurance company will submit a claim to the tree service’s insurance company and they will reimburse your insurance company the ACV amount, plus your deductible. Your insurance company will then send your deductible back to you.

    What you’ve described is how it works. The at fault party’s insurance company only owed you ACV whereas your contract with your homeowner insurance owes you replacement.

  2433. February 20th, 2019 at 9:29 pm #William

    I’ve discovered mold growing inside a wall between a bathroom and bedroom. Just above that wall is an attic AC unit. No one can definitively say where the water is coming from. There appears to be no leak from the sink or toilet pipes (though they appear corroded a bit).

    My best guess is there was a blockage in the AC unit at one point causing water to overflow from there. My worry is the insurance is going to say it the damage was due to poor maintenance.

    If there currently isn’t any blockage, yet they cannot determine where the water is coming from, will the insurance still cover the repairs to and mold removal?

  2434. April 25th, 2019 at 6:04 am #Hurricane Michael

    My Cat 5 Hurricane Michael claim has hit a brick wall. I reported my field adjuster for trying to sway me to his chosen contractor. I have been harassed by field adjuster and his boss and now my desk adjuster is hostile. The company refuses to reassign my claim to another desk adjuster. This sounds pretty sketchy to me!
    Thank You.

  2435. May 9th, 2019 at 6:11 pm #Jason

    Hurricane Mike,

    I don’t know what advice to provide. Keep trying to get your claim re-assigned to someone you can work with.

  2436. May 9th, 2019 at 7:07 pm #Jason

    William,
    I don’t know. The adjuster will have to assess the situation and then the facts of the occurrence will have to be compared to the policy coverage, limitations, and exclusions.

  2437. August 4th, 2019 at 11:15 am #Matt

    My wife and I purchased a Valuable Personal Property policy as an add-on to our USAA homeowner’s policy in Virginia. We insured my wife’s engagement ring as a scheduled item, and for the amount of our appraisal, which we sent to USAA when we took out the policy. We recently lost the ring, which is heartbreaking. Even worse, USAA now cites policy language that despite charging us premium based on this appraised value, they are allowed to use a wholesale jewelry service to replace the ring and about 1/2 the appraised/scheduled value. Furthermore, this company doesn’t offer the lifetime cleaning/resizing/warranties that our jeweler offered when we bought it, so I don’t even see this as a reasonable replacement. They are only offering to cash us out at that 1/2 price, but seems to me we should be able to go back to the same place we got the ring from.

  2438. August 26th, 2019 at 7:28 pm #Bill

    When it comes to water damage from a burst pipe, what determines if something needs to be replaced? For example, I had several boxes full of DVD’s that got completely soaked. I assume that a disk will work fine even if it has been wet, so the only permanent damage will probably just be some rippling of the artwork on the outside of the cases.
    There were also some electronics that got wet like a sterio, a tv, an old Sega Genesis with games, etc. Do I need to plug these items in once they dry to see if they work? Or is the fact that they were impacted by the water enough?
    Another thing was a bunch of boxes of light bulbs. Again, I assume they will probably work fine once they are dry, but the boxes got completely soaked.
    I also had a pool table in the basement that got completely soaked and had the ceiling collapse onto it. They have mentioned getting the felt replaced, but if the wood ever warps because of the water it could really create a problem.
    Basically, I just don’t want to go overboard with what I am saying is damaged, but I also don’t want to be stuck with a bunch of working but water damaged stuff.

  2439. October 1st, 2019 at 10:12 pm #Courtney

    Hi Jason,

    I have read through a lot of your input and want to say thanks for the “free advice”. That being said, I’m hoping you can help.

    I recently had a CAT 3 leak. CSAA has agreed to honor the claim. My issue is with the carpet replacement.

    CSAA has already agreed to replace all of the carpet on my 2nd floor minus the bedrooms (3), stating they will not replace any carpet behind doors.

    I have read your stance on “line of sight” on this discussion board. I’ve noticed in your responses however, you use terms like “generally” and “an approach that is used frequently” regarding to “line of sight” replacement.

    Aesthetically, it is absolutely unacceptable to me to have mismatched carpet in my home (the current carpet is installed to look like one continuous piece with no overlaying strips or seems at doorways).

    So long story short… my questions are: What is done by insurees in the state of CA other than “generally”, or what is the ‘infrequent approach’ to insure ones carpet doesn’t look peice-mealed back together through an insurance claim? Is it common in CA for the insuree to pay out of pocket to have matching carpet once a portion is damaged?

    I’d like to add: I’ve never filed a homeowner’s claim before. I have no personal property loss associated with this claim. This is my first home purchase and it is a 5 year old newly constructed home. I just want my house to look like it did before the water damage.

    Thanks for your time and input- Courtney

  2440. October 19th, 2019 at 3:55 am #Jabulile

    I have a television that falled when I was at work and it is covered with black ink and it is less than 2 month’s so now the insurents company need an affidavit and I don’t know what to say

  2441. December 31st, 2019 at 2:35 pm #Jason

    Matt,
    The insurance company can either replace the ring or pay you the fair market value of the ring. Since they can purchase it for a wholesale price through a wholesale jeweler instead of a retail price, the price they determine is one that needs to be relied upon. The ring will be replaced with an equal ring or one that is better. The ring would be sent to you and you would sign that you accept it because it meets or exceeds your expectations. If it doesn’t meet your expectations, simply return it and they will provide a different ring that is acceptable to you. Otherwise if you don’t want the ring, you can opt to settle with a payment that is equivalent to what it would cost to replace the ring at a wholesale price.

    Your cleaning, resizing, and warranties are not part of your insurance coverage. Perhaps the wholesaler will provide these perks to you as well. I don’t know.

  2442. December 31st, 2019 at 2:41 pm #Jason

    Bill,
    Your claim isn’t settled until both you and the insurance company agree what’s damaged and an acceptable amount is paid for the damage. If you think things are damaged due to the water, present it as damaged. The worst thing the insurance company can say is no. However, even if they say no, you can still argue your case why you believe things are damaged and should be part of your claim.

  2443. December 31st, 2019 at 2:45 pm #Jason

    Courtney,
    Simply demand that it’s all replaced how it was before it was damaged. Your claim won’t be settled until you and the insurance company both agree.

  2444. December 31st, 2019 at 2:49 pm #Jason

    Jabulile,
    The affidavit is simply your statement of what happened, what things are damaged, and how much it will cost to replace what is damaged. There is no right or wrong way how to say it just as long as you provide the information they are seeking.

  2445. April 2nd, 2020 at 4:24 pm #Mary Jane

    In January a very large oak tree came down in a snowstorm and damaged my deck beyond repair. The root of the tree did the damage including undermining the earth beneath the deck so that my contractor insists that a retaining wall must be built before he will construct a new deck. Safeco/Liberty Mutual paid for the tree removal and they will pay for the deck but they refuse to pay for a retaining wall because one wasn’t there when the tree came down. I pointed out to them that a retaining wall wasn’t necessary before the tree came down but they won’t budge. I could probably find someone else that will build the deck without retaining wall but this would be unsafe. Is there any way to get them to pay for this? Thanks.

  2446. May 19th, 2020 at 2:30 pm #Geoff Pryor

    We are a four person family who own in a single family two-story home in Scottsdale, AZ. About a month ago we noticed a black mark coming down the wall from the ceiling in the garage. After discussing it with the insurance company, they authorized me to “attempt to gain access to the source of the assumed water leak and make enough room for a plumber to gain access”, so I did. They acknowledged that due to the fact the Covid quarantine was still going strong, the odds of being able to get a plumber out to take a look and or make a repair might take some time. The leak was coming from around the toilet flange from one of the toilets on the second floor. So now we’re dealing with sewer water and consequently lots of black mold all the way down the inside of both bulkheads to the slab. Every time that toilet was flushed by the children, approx. 1/3 gallon of water would pour down in-between the walls which showered everything below it with water. The bulkheads/walls were both soaked in water and covered in mold. The house was unlivable. We have a special needs child who is 8 years old. She has severe diagnosed ADHD and OCD. She does not do well with any kind of change, especially considering the fact that like most Americans have been under quarantine, which has really confused her and makes her upset on a daily or sometime hourly basis. We knew we goin to a hotel wasn’t feasible as she doesn’t do well in different surrounds regarding sleeping quarters, etc. Even know we wanted to so badly due to the smell of the sewage and the mold, we blocked off the first floor (living room, kitchen, 3rd bathroom) and stayed home and worked from home. During all of this the kids have been out of school. The school sends us coursework 5 days a week and it is mandatory, it’s not optional. Coverage D of our policy states “UNLIMITED” on our dec sheet. Being we didn’t use any of that and endured some very stressful weeks, will the insurance company compensate us for some of the horrible time we spent in the house? Obviously my daughter falls under the ADA due to her disability. Is there a good chance we can get some monetary compensation? In reality, we could have all gone to a nice hotel and stayed for about 2 weeks, which saved the insurance company quite a bit of money. We’re really looking forward to your response and will appreciate any info you can provide to us.

  2447. June 8th, 2020 at 12:18 pm #Jason

    Mary Jane,
    The insurance company doesn’t do preventative measures and they don’t pay for things that are not directly damaged. If you didn’t have a retaining wall, there was no damaged and they won’t consider it.

  2448. June 8th, 2020 at 12:36 pm #Jason

    Geoff Pryor,
    You didn’t incur any additional living expenses so they would not compensate your for any additional living expenses you did not incur. As far as loss of use of your home, you could make an argument for loss of use of those rooms that were not habitable for a period of time. They might pay for loss of use if you were able to persuade them to do so.

  2449. November 7th, 2020 at 1:32 pm #Jessica

    I had a pipe burst in my kitchen two months ago. I used my insurance company’s vendor for water mitigation and mold remediation. The vendor did a very poor job and left mold all over my cabinets and floors. My adjuster made them return 4 days after the job was completed to remove the moldy items. They broke apart my cabinets in the kitchen and carried them out through my living room and dinning room. They did not have a containment up or an air scrubber to help prevent mold spores from spreading. My home is now contaminated with toxic mold.

    My insurance adjuster said that their vendor provided a 3 year guarantee. It has only been 2 months. Instead of sending out another vendor right away, my insurance company spent 2 months investigating what was damaged by the water and what was damaged by their vendor. Their vendor left water in my air duct for 6 weeks causing mold.

    My insurance company has denied our loss of use coverage to be relocated during this process. For 2 months my family has been forced to stay in our home without a functional kitchen and without central air and now without heat. My adjuster said that my home is habitable and this is just an inconvenience. He said that if we want to be relocated now, it would have to be taken from the mold coverage which is capped at 5k and is used up. I don’t believe my insurance company has treated us reasonably or with good faith. Can my insurance company be held responsible for mold contamination or for the negligence of their vendor?

  2450. November 7th, 2020 at 1:36 pm #Jessica

    I had a pipe burst in my kitchen two months ago. I used my insurance company’s vendor for water mitigation and mold remediation. The vendor did a very poor job and left mold all over my cabinets and floors. My adjuster made them return 4 days after the job was completed to remove the moldy items. They broke apart my cabinets in the kitchen and carried them out through my living room and dinning room. They did not have a containment up or an air scrubber to help prevent mold spores from spreading. My home is now contaminated with toxic mold.

    My insurance adjuster said that their vendor provided a 3 year guarantee. It has only been 2 months. Instead of sending out another vendor right away, my insurance company spent 2 months investigating what was damaged by the water and what was damaged by their vendor. Their vendor left water in my air duct for 6 weeks causing mold.

    My insurance company has denied our loss of use coverage to be relocated during this process. For 2 months my family has been forced to stay in our home without a functional kitchen and without central air and now without heat. My adjuster said that my home is habitable and this is just an inconvenience. He said that if we want to be relocated now, it would have to be taken from the mold coverage which is capped at 5k and is used up. I don’t believe my insurance company has treated us reasonably or with good faith.

    Can my insurance company be held responsible for my mold contamination due to the negligence of their vendor or for failure to complete an investigation in a timely manner?

  2451. November 10th, 2020 at 5:16 am #Ryan

    Our HVAC pump failed, as did the alarm that is supposed to go off letting us know the drain line is backing up. So until the flooring in the hallway began to buckle we didn’t realize what was happening.

    My wife is freaking out because some friend of hers (who is not in insurance or claims or anything of the sort) told her the insurance wouldn’t cover it because we “should have known it was leaking.”

    This can’t be correct can it? This just happened and we haven’t heard from anyone yet. Looks like it was leaking for a day or so.

  2452. January 12th, 2021 at 11:04 am #Moderator1

    Ryan,
    It looks like Jason the main contributor on this website has been missing for a while. And I have not looked at the website in a while either. Sorry! This website was originally built with the intention of contributors being from the General Public. I Ron Cercone do not personally have time To answer everyone’s questions.

    A quick answer to your question is that unless you can push your finger through rotted wood on the floor, the damage is sudden and accidental. Even if the wood has turned black after being wet for several days. If it is still fairly hard, it is sudden and accidental. But be aware there are plenty of insurance adjusters who will try to deny your claim anyway and tell you that it occurred over a long time.

    This topic is covered in detail in the uclaim.com ebooks.

  2453. January 31st, 2021 at 5:18 pm #William

    Hello,

    I have a question about loss of use that I haven’t seen answered. Hope someone can help me with this fairly quickly, would be much appreciated!

    I had a total loss on my house in CA due to wildfire. Insurance has been paying me loss of use for staying with friends.

    I have another home in FL, that’s a short-term rental house. I can show regular income from that.

    Question is: can I move to my FL home, and ask insurance to reimburse me based on the rental income I would not be receiving there (and to clarify the insured property is the CA one)?

    Thanks so much!
    William

  2454. February 3rd, 2021 at 10:35 pm #Moderator1

    I sure would like some of you other people out there to weigh in on Williams question. The whole point of this website is for people other than myself to be answering these questions.

  2455. March 15th, 2021 at 6:16 pm #Melissa

    What are your thoughts concerning coverage under a commercial policy CP 001 0 endorsed with Ordinance of Law protection (policy excludes fences) however, it is for a public school and the fence (and the playgrounnd) were severly damaged by a tree (fence enclosed the playground). Could that be covered by OL due to Ordinance requiring it to be present or does the policy prevail? Adjuster denied payment for that as well as the tree stump removal which heaved the fence out of the ground.

    Your direction on this would be greatly appreciated.

    Do you suggest a book from Uclaim that would pertain to a commercial policy claim?

    I know your time is limited and it’s difficult to respond. I have looked everwhere for the answer (except your ebooks, which I will buy if you think it would help for a claim such as this). Thanks, Melissa

  2456. March 16th, 2021 at 10:10 am #Ron Cercone

    Melissa,

    This answer is just off the top of my head without looking at the policy or your property or the denial letter from the adjuster. if the policy states that it specifically excludes fences, then I would say that the Ordinance law endorsement does not override, unless the endorsement has specific language that it does override the policy exclusion for fences. However, if the policy states that it excludes appurtenant structures, but does not state fences, and if the fence is attached to the main structure, then you could argue that the fence is part of the structure, not an appurtenant structure. Whether or not your adjuster or supervisor wants to accept that argument will tell you if your insurance company Is the kind of company that looks for coverage or looks to deny coverage. In other words, the difference between Chubb insurance, a good company, and that chickenshit insurance company that advertises on television every 10 minutes about how great they are.

  2457. March 18th, 2021 at 4:36 pm #Jason

    William,
    Yes to your question. You have two properties. You have to live in one and the other one you don’t have use of. If you are foregoing the loss of rent from the one in FL, you are losing out from the loss of use but now you don’t have extra living expenses. (Your really do, but it’s in the form of not receiving rental income because you are living in the FL home and not getting rental use from it.)

  2458. March 18th, 2021 at 4:44 pm #Jason

    Melissa,
    I think the coverage to which you refer is Ordinance or Law coverage. To make this simple, this coverage provides for any expense to bring the damaged property to current code while repairing or rebuilding. If the main policy excludes coverage for fences, this is not the coverage to be looking at for any endorsements to give back the coverage for fences.

  2459. June 15th, 2021 at 9:53 am #Irena

    I live in Louisiana. In 2017 fallen tree destroyed my garage and adjoins shed. The contractor rebuilt this structure under insurance claim for 34K. My garage and shed was all wood, single car, one floor (16’x 18’). Totally overcharged; real lumber wood was used only on frame and siding. In 2020 when I observed water damage on all corners, window trim, door, door frame, door trim I hired carpenter to work on replacements and found out that; instead wood for trim he used finger joints wood, did not install drip edge, ¾ inch gap between roof sheeting and facia board, no flashing around the window or the door, water damage was so extensive around the door that not only went through OSB board but 2×4 on the structure frame started rotting. I had to replace 2/3 of one wall with the door, trim on every corner and install drip edge. 3.5 years later I spent already 5K on repairs. I am unsuccessful with my attempt to communicate with the contractor and was wondering if my previous Insurance company that paid the claim is obligated to help me with this. Or this is totally a responsibility of my contractor under construction warranty. Your advice would be very much appreciated.
    Thank you,
    Irena

  2460. July 10th, 2021 at 9:32 am #Ron Cercone

    Irena, Not sure what happened to Jason, so I will offer you my comments. The only recourse you would have against your insurance company would be if they were the ones who recommended this contractor.

    Otherwise, you should contact the State Contractor Licensing Board to see if there are any other complaints against the contractor. And if he is still in business, open a complaint against him. At least make a record of it, so that other people can’t see. Good luck.

  2461. November 16th, 2021 at 6:53 pm #Warranties protection plan. After a severe rainstorm, water leaked through the bedroom ceiling. The leak damaged the drywall as well as an antique chest of drawers. What would be the position of the warranty provider on these damages?

    Warranties protection plan. After a severe rainstorm, water leaked through the bedroom ceiling. The leak damaged the drywall as well as an antique chest of drawers. What would be the position of the warranty provider on these damages?

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