how do we deal with a claims adjuster from hell

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PostPosted: Fri Jul 30, 2010 10:30 pm   Post subject: how do we deal with a claims adjuster from hell  

my husband myself and two children ages 13 and now 18 have been living in a hotel for over 30 days . a dump truck delivering soil to our home rolled into our home the truck was all the way threw the livingroom into our kitchen thank god no one was seriously hurt but alot of damage has acourd the insurance lady is the only one in this area so we can not ask to change she is telling us we r not going to be covered for our living expences and our stay at hotel is up we have not been allowed to submite any of our estamets for othe contractors or carpet bids all she wants to do is use her guys i donot understand i thought we had the rite to choose who works on our home i have all the respts and different documentation that she said she needed she wouldnt even look at it she emeditly start off with we wont pay for living expenses the fire dept had told us we couldnt be in the home untill inspectid so what were we sapose too do i am at a loss my husband is realy at a loss this is going to finanaily strap us please help

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PostPosted: Fri Jul 30, 2010 11:06 pm   Post subject:   

First, let's start with the obvious question.... who's insurance company... yours or theirs? Regardless of the answer to that important question... what about the other carrier (your or theirs)?

"Living Expenses" is a broad term. They won't pay for things like food as you'd have those expenses anyway. They should be paying for expenses that you'd otherwise not have.

What do you mean by "our stay at hotel is up"? They are not paying for this any more? Again, why... if the repairs have not been done? Can you now move back into the home?

Regardless of who the carrier is, you can pick your own contractors. This does not mean the insurance company will give you a blank check but they should make sure that their payment is sufficient to address an average cost of repair. If the insurance company is determining the amount of the cost then they should give you an itemized list and you should be able to give this to the company you want to make the repairs. If they can't do it for that amount I'd have them call the adjuster to discuss.

Again, when someone tells you they can't pay for something, you need you ask why... and then share this info.

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PostPosted: Sat Jul 31, 2010 1:21 am   Post subject: insurance  

WOW!! What a horrible thing to happen!! I'm curious: did they give the driver some kind of breathalizer test? What was the REASON he rolled over? It sounds like the Insurance comapny isn't taking into consideration you CANNOT move back into your home yet, etc. (Of course, just my '2 cents').

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PostPosted: Sat Jul 31, 2010 12:25 pm   Post subject:   

did they give the driver some kind of breathalizer test?

Why? No one is alleging drunk driving. Accidents like this "happen" often enough. Someone forgets to set a parking brake, the vehicle slips out of gear. No breathalyzer test for that.

tcope brings up the most important discussion. Which insurance company is being discussed?

If there was negligence on the part of the truck driver, 100% of the OP's loss (hotel expense, cost of meals over and above what would be spent to make those meals at home, any other unusual living expenses as the result of being forced out of one's home) is payable by the driver's insurance company, up to the limit of liability -- assuming he is insured.

It could be covered under a trucker's/contractor's Commercial General Liability policy or a form of Commercial Auto Policy.

It sounds like the Insurance comapny isn't taking into consideration you CANNOT move back into your home

No it doesn't. Here's where emotion and insurance mix like oil and water. There's a big difference between what one thinks an insurance company should do, and what the contract of insurance requires (or limits) them to do. People often lose sight of this reality of insurance.

I'm guessing that the insurer being discussed is the OP's homeowner's insurer. Typical policy language for "living expenses" is 30 days. Broader coverage is available, and usually described in terms of dollars instead of days. Has nothing to do specifically with being able to move back into the home or not (but if the house is ready to be lived in, the claim would end).

The standard provision envisions having to evacuate the home for a brief period of time due to conditions beyond the control of the insured, not an extended time away due to an uninhabitable dwelling (like the time it takes to remediate smoke and water damage following a fire -- 5-10 days or so -- as opposed to the many months it could take to rebuild the damaged portion of a structure).

Persons who must leave due to the lawful order of police or fire officials (imminent threat of disaster) and cannot return to their property for some time, for example, can also file a claim for "living expenses" for up to the 30 day limit (or longer if they have broader coverage).

So if the 30-day limit of their homeowner's policy has been reached, and the home is still not in a condition to live in, then a new claim needs to be made against the driver's insurance company. If the claim is being paid by the driver's company already, there should be no discussion of "30-days".

tcope has adequately addressed the business about who can make the repairs and for how much.


CA-licensed Life & Disability Analyst. CA Insurance Lic #0596197. Also investigating insurance company abuses, and providing litigation support/expert witness services. Send me your questions, and I'll send you my answers.
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