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 Posted: Thu Jul 14, 2011 7:02 pm Post subject: Insurance shooting down their own adjustors |
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Our house was damaged in a tornado this spring. We had a large tree smash one side. The insurer sent out an adjustor who said he believe the damages would exceed our cap. He requested his supervisor come take a look and call out a structural engineer. The boss signed off on the engineer.
The engineer came out, walked around, used no tools, and only spent about 30 minutes on site. His report reflected his flippant attitude towards the job, failed to address several points (one being a major structural characteristic of our historic home), and doesn't come close to the real scope of the damage. The original adjustor was forced to base his claim on that report and we were issued a check for about 35% of our cap.
We explained we didn't feel this was accurate and barely covered a third of our contractor's bid. Since, we have had 4 more adjustors come through the place, 3 of which all believe the damages exceed our cap and one that refused to say either way. However once the claims are sent in for approval, they are shot down by the paper pushers because they are at odds with the original engineers report.
We are now 3 months in and have yet to see a claim amount that comes close to what our contractor believes will actually take to repair our home. The insurance company refuses to accept the report is flawed and we are at our wits end. We don't want to use a public adjustor, but we are naive to what our rights are. We are waiting on yet another adjustor's numbers at the moment, but have no illusions about how it will turn out. He will submit his claim, which will exceed our cap by 100k or more, the paper pushers will deny it and send out his supervisor, his supervisor will support his claim so they will send out another adjustor.
We keep hearing, "You can submit supplements for that", but honestly there are problems with that. First being supplements are not intended to be the bulk of the claim, which they would be in this case. Second, if we exceed our cap (which appears likely) we are out of pocket which isn't feasible. The house is only worth 150k, putting 270k into repairs might make it right again, but doesn't make financial sense.
What should we do? Hire our own engineer (which they have agreed to "look at" but will be out of our pocket & no promises)? Report them to our state's insurance commission? Threaten to sue? Demand arbitration? We never thought we'd be here in 3 months, we can't sleep, live like gypsies, my work is suffering, and can't kick this cold I've had for three weeks. Anyone been here or could at least suggest what they might do?
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Max Stress
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| Posted: Fri Jul 15, 2011 12:23 am Post subject: |
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| Quote: | | However once the claims are sent in for approval, they are shot down by the paper pushers because they are at odds with the original engineers report. |
You may want to invoke the appraisal clause since this is an issue on the extent of the damages. Refer to that portion of your policy for more specific information. Basically you have your own appraiser (could be one of those contractors) submit their information and then you both hire a 3rd party to arbitrate |
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tcope
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| Posted: Fri Jul 15, 2011 2:54 pm Post subject: |
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Thank you tcope, I'll have to check out my policy to see how that works tonight.
My adjustor called again lat night to say he had a new claim worked up and would have the numbers in our hands by the end of the weekend. I'm sure it will be marginal update, but no where near where we need to be.
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Max Stress
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| Posted: Fri Jul 15, 2011 3:51 pm Post subject: |
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Is this an actual cash value policy and not a replacement cost policy?
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tcope1
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| Posted: Fri Jul 15, 2011 6:52 pm Post subject: |
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I'm sure I understand the question, but it's a run of the mill home owners policy. The policy will cover our loss up to 235 if it's declared a total loss (which it was not). However, if we rebuild we can actually go as high as 235 + 20% (and +10% for code upgrades).
We don't dispute that the property can be repaired (anything can be repaired), however, we feel as though we could very easily exceed the 235 + 20% from what our contractor is saying. Which, would make it a total loss.
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Max Stress
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| Posted: Fri Jul 15, 2011 6:57 pm Post subject: |
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OK I had to look it up. Yes, it's a cash value policy if I understand correctly...
The insurer will hold depreciation until the job(s) are complete. Thus if we don't rebuild we would forfeit the deprecation for all but the demo.
The adjustor said the depreciation is based on his numbers, not our cap. So if he comes up with a claim of 300 with (for easy math) 10% dep we would be looking at 270. Which they would just cut us a check for our cap which 270 is beyond that.
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Max Stress
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| Posted: Tue Jul 19, 2011 2:22 pm Post subject: |
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Well we finally heard back from the insurer today, they offered another 46k which puts us at about half of what our contractors have stated we need to fix the house. I called our claims handler (voicemail) and let her know that I was formally requesting they send the engineer back out to do an another walk through. If they choose to no do so, I'd be hiring my own engineer to work up a report, and would have no choice but to file a complaint with my states insurance commission.
Beyond this, I'm not sure what to do. My contractor has also put in a call to her to state the same. I guess if they choose not to do so, my recourse will be to do the above and demand arbitration or lawyer up. Does anyone else have any advice?
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Max Stress
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| Posted: Wed Jul 20, 2011 1:18 pm Post subject: |
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I can't seem to fine the answer to this anywhere. If we were to invoke the appraisal clause, does that remove our rights to file supplements there after?
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Max Stress
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| Posted: Wed Jul 20, 2011 3:14 pm Post subject: |
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| Quote: | | If we were to invoke the appraisal clause, does that remove our rights to file supplements there after? |
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| Quote: | | We don't want to use a public adjustor, but we are naive to what our rights are |
Stop fooling around and hire a public adjuster -- it will cost about 10% of the recovery, and you are far more likely to receive the full value of your loss (up to the policy limit).
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MaxHerr
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| Posted: Fri Jul 22, 2011 3:05 pm Post subject: |
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Just not going to happen MaxHerr. We made the call to go it alone, and are sticking with that decision, perhaps to our folly. There is nothing about the PA system that sits well with me. I'm sure they provide a valuable service, but it's not one I'm interested in using.
Our structural engineer came through yesterday and is working up his report. He found several omissions and errors in the original report that really change the scope of the damage. Without going into detail, these errors could create a liability issue for the original engineer and if presented a copy, they would probably want to re-evaluate. Well allow me to rephrase, he stated that if an engineer in his firm came back with a report as flawed as this one, he would want an opportunity to amend before it got to the point of litigation.
So our plan is to allow the original engineer an opportunity to revise their report which would cause our insurer to "reboot" their adjustor process. If this works, fantastic, if not we still have the option of invoking our appraisal clause, with the added benefit of additional documentation.
As always, I'd welcome anyone's input on our situation (I sure wouldn't be posting here if I didn't).
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Max Stress
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| Posted: Sat Jul 23, 2011 2:44 am Post subject: |
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No problem. Some folks get intimidated by the insurance company's process. So if you aren't, fine. Just stick to your guns and press for what you believe is fair.
Above all, as long as you don't become unruly or argumentative or threatening (especially over the phone), you won't antagonize them and the lines of communication will remain open.
| Quote: | | before it got to the point of litigation. |
This is the only reason I was suggesting the Public Adjuster route. The PA can usually negotiate as good a settlement as any lawyer will get in a civil judgment (excluding any "punitive" damages). The difference is that the PA will take 10% and the lawyer will take 30%-40%. You'd come out ahead with the PA in such a case. That's all.
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MaxHerr
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| Posted: Tue Jul 26, 2011 5:07 am Post subject: Insurance Shooting Down their own adjusters |
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I am going through the same situation as you are. I for one dont get it, why do the Insurance carrier, the Adjuster and Engineer want to do shoddy worK? It does not say much for their profession, either they have no clue, or they are just plain dumb !!! I actually received the partial advance payment for the repairs though I was disputing the amount the entire time. I was an Adjuster, and I know the policy in and out, I know what coverages and exclusions are. The IA (Independent Adjuster) they sent out was trying to tell me that the nail pops, and the warped flooring and the door trim, was already there I just didn't notice them and didn't look for them before the tornado. I built the house, I know what was there, and what was not. He was rude, would not consider anything I wanted to show him, which was really idiotic, and created so much more work for him and the Company. I will not quit untill they honor their agreement.
I know the nightmare, as I said we thought we would start the repairs, the roofers, could not line up the metal, it was so obvious, that the wind damaged the structure. I would not want to look like such fools and say that it was not damaged these 2 guys look like dummies!!! For what? To save the Carrier money? They dont want to save money that way, it is not worth it. I am finding a letter to the President has made more "jumps" to my aid than any other attempts at getting resolution. When my engineer has completed the report, The CEO, will get a letter and I am sure my check will be overnighted if not personally delivered. i would not mind having the flunky IA deliver it to me.
That is horrible to say, but some people dont know enough to learn more !!! |
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gypsylady1
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| Posted: Mon Aug 01, 2011 7:50 pm Post subject: |
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I hear you gypsylady1, I have no idea how they can justify this behavior. Their own adjustors and field reps have called it a loss, so for the check signers to shoot it down is beyond me. Furthermore, I'd think the engineer has put his firm is real legal thin ice by signing off on such a flawed document.
Thanks MaxHerr, it's an interesting point you bring up. We have no intent to litigate at this point, but the insurance folks sure seem to be pushing us in that direction. About 3 times a night we have some lawyer on TV telling us that we are getting screwed by our insurance company, my hand involuntarily reaches for the phone every time.
Honestly, if we could find a PA that would be willing to take it on for what is left of our claim, I'd consider it. But we have settled our personal prop, and are about 55% of where we need to be with the house now (still 95k on the table). Imagine if you were halfway through painting your house and decided to hire a painter, who wanted to charge you for the whole house. You'd tell him to get bent, but that's the reality of a PA.
As for our actual claim, the new engineer's report should have been faxed over by our contractor this morning. I'm not sure how it will be received, but my expectations (complete indifference) have already been exceeded by them asking for a copy. I guess we will see what they have to say (if anything) and take it from there.
I did notice that one line item we were already paid for on the first adjustor's report seems to have disappeared from this new report. I contacted my claims expert and she said the new report completely replaces the original (as opposed to amending it), so I guess I'll file a supplement for that.
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Max Stress
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| Posted: Tue Aug 02, 2011 7:47 am Post subject: Tornado Damage and Home Owner Claims not being fairly settle |
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If the company sends an Independent Adjuster, and he misses his appointment with no call advising he is running late !!! Start worrying, If the IA says damages were in your home before the storm start worrying!!! If you have nail pops in the shhetrock, check all of the trim around windows and doors, most likely you will find the trim has been pulled away from the sheetrock. Check the Attic, to make sure all joists are still connected, check csheetroc at the ceiling areas. Hang in there !!! My Carrier I think will be ok, but Southern Property Adjusting service in Cumming GA is a complete disaster, and does not pay claims, or does not understand that the purpose of insurance is to indemnify the customer back to the same way they were prior to the occurrence. It's beyond ridiculous
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GypsyLady2
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| Posted: Tue Aug 02, 2011 8:44 pm Post subject: |
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Update! So our claims handler called and said the report has been received and would be forwarded on to the original engineer to be reviewed. Not a giant victory, and perhaps I've been at it too long and I'm seeing phantoms, but I thought her tone was more subdued.
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Max Stress
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