Insurance company claim probs; sends to their attorney...

My family recently claimed some hail/wind damage to our home. The storm was on April 9, 2011 and the claim date was March 21, 2012. I realize that this is quite some time to wait to claim damages, but the family had never filed any claims previously and we had no idea that there was any damage to the home besides the A/C unit being dinged up and not cooling efficiently. At first, they sent an adjuster out to look at the roof and she confirmed the damage and said a check to replace the roof would be sent out (minus $1000 deductible and minus depreciation). Before the adjuster left, my mother brought up the topic of other damages to our home. These damages included loose siding, dents to our upper level fascia, and damage to our A/C unit. The adjuster said that she wouldn't look at it because we would have to file two claims and that "wind and hail never occur at the same time." With that said, we let her go on her way. We later researched and called the weather experts about the storm and the statement that the adjuster had said to us. These weather experts were amazed that she had said such a thing. They said that it could lightning during a snow shower and that it does indeed hail when there is wind present. The total that was sent for the roof was around $3.9k. So, later on, my mother called the insurance company and spoke to the adjuster and the adjuster would not reconsider her statement even after telling her about the government weather expert's statements. After a few days, we called the claims manager to talk about this issue and she said that she would speak with the adjuster. The next day or so, the claims manager calls and said that the adjuster never stated such a thing and that it was a "misunderstanding."

This leads to the claims manager deciding to send a second adjuster to our home. This adjuster was 30 minutes late, didn't knock on the door, and was rude during the entire inspection. He even took pictures of things that we never said that we were claiming was related damage (such as our mortar cracking a bit on our steps; this adjuster later claimed that we said that this was hail damage in his report...). The adjuster completely lowballed everything. He gave us $100 for out A/C unit and about $1000 for a $10000 siding job. The siding is very loose. We have contacted many contractors and they said that they would definitely not come out to a home to completely rehang loose siding on a home for just $1000. The $100 is supposedly to "comb" the coils of the A/C unit that was dented. Combing the unit would not fix it as there is a rattle to the fan as well as a leak in the frion. The fan was replaced with a new one before the storm occurred. Also, this unit has a fairly new compressor in it which was replaced under warranty. The rudeness of this adjuster as well as how he took pictures and claimed that we said we wanted to claim those things really makes the company look unprofessional. A few days after, we called the claims manager and she was very stern and rude during the conversation. She stated that they were not going to pay another dime and that the insurance company can put "purple bandages" on our siding if they wanted to. This statement in itself was just uncalled for.

After 2 months of this ongoing claim, the insurance company decides to completely lock our insurance file from view from any and all employees and they send it to their attorney. The local manager for the state called us (after my mother had called him about the claim and he had been gone on vacation for a week or so) and he said that he was sorry that this was happening to us and that in his 20+ years of working with the company, he had never seen such a thing as a claim being sent to an attorney. We could not converse with anyone about dropping our insurance, lowering our coverage on our cars (this company insures our cars and the home), or anything of that sort. In addition, our policy had stated that we could request our privacy information as well as a full copy of the policy and that we would receive it within 30 days of opening a claim. The insurance company had only recently given this to us after 3 to 4 months... So, after many emails back and forth between this attorney, the attorney decides to send an engineer out to check our A/C unit. We felt we had no choice but to cooperate as that is what it says we must do in the policy or the claim could be closed. The engineer came out and all he brought to the A/C unit was a camera, a tape measure, and a flashlight. Before the inspection, we decided to have an A/C contractor present in addition to a total of 4 people to witness the inspection. Also, we video recorded the inspection for documentation. All the engineer did during the 30 minute inspection was take pictures of things. He didn't even open up the unit or go under the house to look at the secondary unit, nor did he even do any tests with any gauges or equipment to test for leaks, etc. At the time, we had window A/C units in our bedrooms (and still do) and it is 90 degrees in the other parts of the home. It's been this way for a few months now. It gets even better. When we finally got the engineer's report in an email, the engineer had claimed that we had said some things were hail damage when we stated that we didn't know what happened to it, but it wasn't there before the storm. The engineer also said in his report that there was no frion leak. How could he have known if there was a leak or not when you must test for this with proper equipment? You cannot see or smell frion leaks from what we were told by contractors. This whole inspection seemed completely set up. Even the A/C contractor said "He didn't even check the frion! This is a joke!" during the inspection.

Now...after all of this, the attorney has recently sent emails stating some things. One thing is that they said that their intentions were correct about us claiming things that were not covered in the insurance policy. The other thing is that the attorney stated "I feel obligated to direct you to the provision in your policy referring to Fraud and Concealment." The fraud and concealment part was even boldfaced as if he were suggesting something to us. Now, we are setting appointments with attorneys for information on what our options are at this point. My mother is the one who owns the policy and the home. I feel that if they try to claim fraud on my mother that she may not be able to find any other insurance company (as we plan to drop this one for another company after all of the anxiety and stress this whole 4 month ordeal has caused us) and that she may get something on her criminal record which may prevent her from obtaining any jobs in the future. We are currently in a low income situation and I feel that the insurance company is taking advantage of us as my mother had filed for bankruptcy back in 2005. They know that we cannot afford a per hour attorney. This is why we are trying to find someone to take this on a contingency basis but we have had no luck thus far.

Sorry for this sort of rant but we feel helpless at this point. We can't get the A/C unit fixed as the insurance company only gave us $100. We haven't cashed the checks yet (other than the roofing one) as we are afraid they will try to pursue charges against us if we were to do so. By delaying the completion of repairs, we are losing time to get depreciation back. In only 2 months, the depreciation will be no longer valid for any repairs and we have yet to complete any repairs on the house that were claimed. I recently graduated from a 4 year university and we had to cancel my grad party due to the heat inside our home. I will never be able to live that day again and I feel the insurance company's in-cooperation to pay to fix our nonworking unit has caused all of this. Not to mention, all of the stress that my 50+ year old mother is having over the whole ordeal... I'm afraid that it may cause health problems if it goes on any longer.

Again, sorry for this being such a long post. This company had great monthly rates and we had them for over 10 years and had never made a claim, yet they go to this extent with us even after we obtained over 10 estimates from various contractors stating the damages... I just hope this will be resolved soon. What do you guys think we should do at this point? My mother is constantly saying that she wished she had never made this claim on her home. This insurance company is horrible in our eyes at this point for everything they are putting us through...