Can i file a claim and not get the work done?

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PostPosted: Sat Nov 06, 2010 4:53 pm   Post subject: Can i file a claim and not get the work done?  

I have filed an insurance claim for Hail damage for roof. The adjuster came in and processed the claim. I got a check for Roof Repair cost - Deductible - Depreciation adjustment. I was told by the insurance company that i can get the depreciation adjustment amount reimbursed when i get the work completed and provide them proof of work completion.



Now i had called couple of contractors and they looked at my roof and they said there is hail damage signs on the roof but my roof doesn't need to be necessarily replaced.



So now my questin is can i keep the money without getting the work done? Question

Since i wont provide any proof of work completion and request for reimbursement of depreciation adjustment amount from my insurance company will my company close the claim after 180 days or will they come behind me to get the work completed?


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PostPosted: Mon Nov 08, 2010 10:39 am   Post subject: Damage  

Most states have a blurb in insurance law that insurance is not to be used as a means to profit from claims payment. If you don't fix roof or at least address damage portion then guess what...insurance company can non renew on basis of 'existing damage' and thus you are uninsurable for many companies. It can be a catchy situation and then you may be stuck!


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PostPosted: Wed Nov 10, 2010 2:47 am   Post subject:   

I think your reputation could take a beating with your insurers as it could be considered a fraudulent claim. So try to use insurance for what it is ideally meant for, helping you during emergencies.

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PostPosted: Wed Nov 10, 2010 8:48 pm   Post subject:   

Quote:
Since i wont provide any proof of work completion and request for reimbursement of depreciation adjustment amount from my insurance company will my company close the claim after 180 days or will they come behind me to get the work completed?




Quote:
a blurb in insurance law
and
Quote:
your reputation could take a beating with your insurers as it could be considered a fraudulent claim




Understand this, if there was no damage to the roof, the insurance company would not have paid a claim. So I would call a couple more roofing contractors and get some additional opinions. Regardless, you are not obligated to have the work done, and may keep the insurance payment. The insurance company has no responsibility to, nor will it, perform the repairs you choose not to make. It is not the property owner. (On the other hand, a lender could do that, if the loan contract permitted it to do so, and add the cost of the repairs to your outstanding debt.)



There are no "blurbs" in insurance codes -- and the concept of profiting from insurance is known as INDEMNITY -- which is what insurance does, it indemnifies us (makes us whole) following a loss. Damage to the roof costs money to repair, and the insurance company in this case has done that. This is NOT fraud -- because fraud requires INTENT TO DECEIVE or an attempt to gain an unfair advantage, or to file a false claim -- because the loss followed a covered event (hailstorm), nor it does not prevent you from having insurance as the two previous posts each suggest in their own ways.



You simply cannot make a second claim for the same unrepaired damage when the next hailstorm passes overhead. That could be attempting to profit and could be fraudulent.



If you don't complete the repairs in a timely fashion, the claim file may be closed, but can almost always be reopened for good cause. "I didn't have enough money to pay for the entire repair," is not good cause, since the insurance company has agreed to pay the difference between its claims payment and the actual repair bill. If you can complete the repairs for the amount of money you have in hand, there is nothing else to claim.



If the roof is damaged, and an additional loss occurs because the existing damage was not repaired, then the additional loss will probably not be paid by the insurer due to the provision (found in all property & casualty policies) that states, once damage has occurred, the property owner must take all reasonable action to prevent further loss. That includes receiving a claims payment and using the money to effect the repairs.



So be sure you do the right thing . . . winter is coming and rainwater can be more problematic than hail -- which is why it is almost never covered as a primary cause of loss. If the existing, unrepaired hail damage allows rainwater to intrude and does additional damage, it will not be covered as a contingent loss.


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PostPosted: Thu Nov 11, 2010 3:03 am   Post subject:   

Ok so this could be one of those rare insurance claims where policy holder could gain some thing from the company with out being fraudulent.

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PostPosted: Thu Nov 11, 2010 5:47 am   Post subject:   

Quote:
Ok so this could be one of those rare insurance claims where policy holder could gain some thing from the company with out being fraudulent.




WHAT?



FACTS (as posted): There was a covered loss, the insurance company pays a claim for the covered loss. The insured takes the check and does not make the repairs. The damage remains.



Tell us, Goody, who has gained anything here? What have they gained?



There is no requirement that the insured use the money for the repairs. The insurance company merely honored its contractual agreement. That's all that happened. There is no fraud, there is no gain, but there is a loss that remains unrepaired.



If your car is involved in a collision, and the damage is $1000, and the insurance company says, "OK, we're paying the claim, minus your $500 deductible." You thank them and get a check for $500. You use the money to buy a new suit. What have you gained? If you think the insurance company bought you that new suit, you're mistaken.



In the meantime, however, your car is still damaged. You cannot call them a week later and say, my car was in an accident, and collect for the same damages (although people try to do that all the time).



The OP simply cannot make a second claim for the same damage, that would be a crime. But if he later repairs the original damage and the total cost is more than the ACV that was paid initially, he may be able to get the insurance company to pay that additional amount, as it would if he makes the repairs ASAP. But normally there is language in the contract that limits the amount of time one has to file a claim -- typically 90 days, and by state law, usually not more than one year.


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PostPosted: Wed Dec 15, 2010 10:15 pm   Post subject: Re:  

Experts recommend that if you have a lot of assets you should get enough liability coverage to protect them. For instance, if you purchase $50,000 of bodily injury liability coverage but have $100,000 in assets, attorneys could go after your treasures in the event of an accident in which you're at fault and the other party's medical bills exceed $50,000. General recommendations for liability limits are $50,000 bodily injury liability for one person injured in an accident, $100,000 for all people injured in an accident and $25,000 property damage liability (that is, 50/100/25) given that half of the cars on the road are worth more than $20,000. Here again, though, let your financial situation be your guide. If you have no assets, don't buy excess coverage.

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PostPosted: Thu Dec 16, 2010 11:17 am   Post subject:   

Quote:
Experts recommend that if




Irrelevant to the discussion.


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PostPosted: Mon Dec 20, 2010 1:35 am   Post subject:   

Got lot of good information about the insurance.. I must say that insurance is one of important thing in our life and we people must for it according to requirement.

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PostPosted: Wed Jan 05, 2011 3:30 am   Post subject:   

This is what gets me the most, you have a claim and get Insurance money and once the work is done, you get the deprectiation amount. But, instead you allow greed to take over. You will have a new roof and no out of pocket expense? Whats the problem with that, Homeowners should start getting put in jail for this. It is fraud and I hope you keep the money, spend it, and months go by and your roof has severe problems. Then, you can pay out of pocket for the whole thing. Karma always wins


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PostPosted: Sun Jan 30, 2011 5:16 pm   Post subject:   

Max is absolutely correct and outlined the reasons very clearly. The property you insure has damage, the company pays you money for the depreciated value of loss. If you chose not to repair, then the loss of value of the property is off-set by the claim money...what you do with the money is your business. Of course you need to clear this with your bank as they may require you to complete repairs.



Keep in mind, it depends on the severity of the hail damage too whether this makes good sense if you chose not to repair though. We had a county wide hail storm a couple years ago come through our area, we replaced a lot of roofs. But we had several customers that had newer homes w/ 30 yr architect shingles that held up very well. Although they were hit, it's the property owners choice to live with it or replace...either way he gets the check. An adjuster cant write to repair a shingle, so the only option is to replace any and all damaged shingles...so in a light hail storm, if more shingles than not got pelted....ie new roof. For a homeowner with a newer roof w/ very minor granulation loss it may work best for him to not replace, but to use the money for other needed repairs or even pay down the mortgage; and and although the roof took some minor damage, it would still perform well for another 10-15 years, maybe more.



You are now seeing recoverable depreciation included in policies for this very reason. It pays you ACV and the the difference once repairs are completed. You are owed replacement, but only if you replace...so if you decide to not complete the repairs, the insurance company protects itself by not having to pay the recoverable deprecation.



The opposite happens as well. One of our elderly customer's had a roof that looked like a 30 year old 20 year roof. It should have been replaced a long time ago. When the storm came through, it pelted his roof and he had replacement coverage. He got a brand new roof and was very happy to replace his roof as you can imagine.



There's nothing wrong, fraud, or illegal in this type of settlement.

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PostPosted: Fri Apr 13, 2012 3:18 pm   Post subject: Insurance Claims  

I figure I purchase insurance for the purpose of covering any damages I may get to my property, whether it be my car, my house, my roof, etc.... If I get damage and receive a claim settlement, the insurance company has just done what I have been paying it to do. If I do not get the damages fixed it is my choice. I only received what I have been paying the insurance company for all along, all those years that I did not file any claims. Basically I am just getting back some of the thousands of dollars I have spent.


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PostPosted: Wed May 02, 2012 12:41 pm   Post subject: Amount of damage repaired  

I was cut a check for $1,000 bucks by my ins. co. My auto body co. said they could save me $. They did not repair all of the work my ins. co. said I needed to have. But they did about half. I sent in the form to my ins. co. that the work had been completed. What happens now? Will they reinspect my car? what happens if they see that not ALL work was repaired? Does it effect the value of my car? I wasn't trying to commit fraud or anything. I did get half of the work done. My body shop guy said I didn't need the other work done and agreed! I kept about $400 and got new brakes.


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PostPosted: Wed May 02, 2012 1:14 pm   Post subject:   

Quote:
if they see that not ALL work was repaired? Does it effect the value of my car?


The insurance company could care less. They paid you for the repairs they believed were necessary. If they truly weren't, fine, the adjuster was an idiot. If they were, and you did not make those repairs, then you are the idiot.



On the other hand, the idiot might be the mechanic who told you the repairs were not necessary, and you simply relied on that statement. You might want to have the vehicle inspected by a third-party mechanic to be on the safe side.



The value of your vehicle has been affected simply by virtue of the damage and repairs, whether complete or not. If there are additional repairs that need to be made, but haven't, those will also affect the resale value.


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PostPosted: Thu May 03, 2012 3:13 pm   Post subject: not repaired  

First off - thank you for providing some very clear and knowledgeable answers to these questions. It took some searching to find somebody who seems to know what they are talking about.



I received $3000 from my insurance company for a $6400 roof replacement - (this is not my question, but I feel like I got screwed on that deal because for hail damage my deductible is a percentage of the insured value, and they made me insure the house for $50K more than it is worth). Anyway, I had a roofer take a look, and he said that there was minor damage, but did not require a whole replacement. So I didn't replace the roof. (this was 2 yrs ago)



Now I am selling the house, and they buyer's inspector noted the hail damage. I immediately had two more separate roofers come and look, and neither of them recommended a new roof. One of them said the roof is fine, and the other said it just needed a couple of vents put in ($500).



I understand from your previous responses that I won't go to jail for not fixing my roof after receiving the insurance money. But the buyer's insurance company could see that the claim was filed, and told that to the buyer. They are supposed to have their own roofer take a look, which seems like the best thing to do, and we'll negotiate from there.



I just want to make sure that I won't get in legal trouble over this. (I am also wondering if the home inspector could see that claim and so just automatically put down that there was hail damage). What will happen when her insurance company sees that a claim was filed, but the repairs not completed? Does that obligate me to get the roof done before the sale?



Thank you for any suggestions you might have.


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