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

by Guest » Sat Nov 06, 2010 04:53 pm
Guest

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? :?:
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?

Total Comments: 93

Posted: 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!

Posted: Wed Nov 10, 2010 02:47 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.

Posted: Wed Nov 10, 2010 08:48 pm Post Subject:

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?



a blurb in insurance law

and

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.

Posted: Thu Nov 11, 2010 03:03 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.

Posted: Thu Nov 11, 2010 05:47 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.



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.

Posted: 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.

Posted: Thu Dec 16, 2010 11:17 am Post Subject:

Experts recommend that if



Irrelevant to the discussion.

Posted: Mon Dec 20, 2010 01:35 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.
[Link removed - Admin]

Posted: Wed Jan 05, 2011 03:30 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

Posted: Sun Jan 30, 2011 05:16 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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