2016 – Our Most Interesting Claims

I have handled many different kinds of insurance claims for policyholders. These are some examples of the situations I encountered and the outcomes I achieved. I did not violate any privacy or confidentiality agreements when writing these descriptions. My goal is to inform policyholders of what they can expect from insurance claims and that an alternative exists other than walking away from a denied or underpaid claim. These examples are not meant to imply that similar results are guaranteed.

Hail Damage to a Commercial Building — An insurance agent sold himself a policy for a commercial structure that he personally owned and that was subsequently damaged in a violent storm of high wind and softball sized hail. He filed a claim and the insurance company’s adjuster inspected his loss, applied his deductible, and wrote him a check for only $127.

The understandably shocked insurance agent attempted to negotiate a fair settlement for his loss on his own but could not get cooperation from the adjuster or his claims department. Eventually, the carrier’s claims department stopped responding to the calls from the agent and from his contractor.  After several weeks of frustration and lack of progress, he contacted me and hired me to assist him with his claim.

After three weeks of negotiating with the insurance company and revisiting the property with a different adjuster, the insurance company agreed to settle for a little over $111,000.00.

You read that right.  After originally valuing the loss at only $127 over the deductible, the insurance company agreed to the existence of extensive hail damage and paid more than $111,000.00 to restore the damaged property.

If being lowballed on an insurance claim can happen to an insurance agent, it can certainly happen to you.

[The agent now sells insurance for a different insurance company.]


Water Damage — After finishing their morning routine and leaving their home for work, the policyholder and his family were unaware that a water supply line in their bathroom had broken. When they returned home at the end of the day, there were more than two inches of water covering several thousand square feet of floor space and wicking up the walls. The insurance company’s adjuster did not convince the policyholder that he was making a fair assessment of the damage and I was invited to assist with the claimThe initial calculation to address the damage to the structure that was provided by the insurance company’s first adjuster was $24,763.83.  After a few weeks of negotiations, we agreed to settle for the full cost of repairing the damage to the structure … which came to $69,764.94.


Hail Damage to a Personal Dwelling — The concrete and asbestos roof tiles were destroyed by a hailstorm and water entered the interior walls of the home. The insurance company offered $28,000.00 to replace the roof and repair the interior … but the homeowner could not find a contractor willing to do the work for that price. One of her contractors referred the homeowner to me to communicate with the insurance company on their behalf. In a shorter period of time than it took the policyholder to negotiate a $28,000.00 offer, I negotiated a settlement for $98,000.00 and she immediately hired a contractor to restore her home to its original condition prior to the storm.


Hail Damage to a Commercial Building — When the claim was first filed by my client, the insurance company said that there was no hail damage to the slate roof. After an inspection by someone the carrier identified as an “engineer” (who wasn’t), the insurance company agreed to pay only $61,000.00 for a partial repair to the damaged roof. Refusing to back down after our negotiations were stalled by the insurance company, we took the claim to appraisal and prevailed with an award of over $130,000.00 to replace the slate roof.

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