Home & Commercial Insurance Claims Highlights – 2014

Home & Commercial Insurance Claims Highlights – 2014

Some have asked what a Public Adjuster actually does for a policyholder. Here are a few of the highlights from 2014 that might interest you …

1. Smoke damage to a two-story home was estimated by the insurance company’s adjuster at being $2,500. The homeowner, who is an attorney, called on me for help.

We were able to reach an agreement with the insurance company to assign a new adjuster, perform a new inspection and to discuss the damages missed by the first adjuster.  We entered new negotiations and the insurance company agreed to pay a settlement of over $35,000.00.

2. Water entered an attached garage through an opening in the roof that was not related to storm damage. The insurance company investigated the claim and determined that the amount of damage did not exceed the home owner’s deductible and offered to pay nothing.

The homeowner contacted a public adjuster who was not successful in getting the insurance company to pay for the water damage (and subsequent mold damage) to the structure and contents. They mutually agreed to end their business relationship with each other and she called me.

I reviewed her claim, met with the insurance company’s adjuster at her property and, after further negotiation, we eventually agreed to accept a settlement of over $16,000.00.

3. A wood-burning stove and chimney caught fire and destroyed a home. The insurance company initially offered $75,392.91 for repair of the structure. The homeowner was unable to restore his home to its original condition at that cost and asked me for assistance.

Wood stove fire

After negotiating with the insurance company, we eventually agreed to accept $100,000.00, which represented the total amount for which the home was insured.  (Had the home not been underinsured, we would have been able to recover approximately 25% more. Some homeowners will unknowingly cheat themselves by insuring a home for what they owe on it rather than for what it will cost to replace it.)

4. At a commercial storage building, part of the flat roof collapsed from water that had collected on it during a storm. The owner of the building contacted me immediately after his insurance company had inspected the building, sensing that the adjuster was attempting to minimize his damages.

Roof collapse

The initial offer to settle on the damage to the building was slightly over $29,000.  After more negotiating with the insurance company, we eventually agreed to accept $41,924.00.

5. Golf ball sized hail pounded his roof for over an hour during a storm and, while all of his surrounding neighbors were having their roofs replaced by their insurer, my client was told by his insurance company that they could find no damage (while it could be easily observed by other professionals). He made several attempts at negotiating his claim with the help of several different roofing contractors, but could not get the insurer to pay. He learned about the existence of public adjusters on the internet and called me. After negotiating with the insurance company, we agreed to settle for the amount of $15,224.36 which paid for a complete replacement of his roof.

6.  Initially, the insurance company advised a homeowner that the damage to his dwelling and personal belongings due to a broken water pipe in the basement was not covered.  The insurance company’s adjuster actually went as far as to suggest to the homeowner that he withdraw his claim.

Basement Flood

When the homeowner did not withdraw his claim, the insurance company’s adjuster explained to the homeowner that even if there was coverage, the damage did not exceed their deductible and asked, again, if he wanted to withdraw the claim.

Instead of withdrawing his claim, the homeowner called me for assistance and decided to hire me to represent him.

After inspecting the damage with the insurance company’s adjuster and after negotiating with their head office, the insurance company finally agreed to pay over $88,000.00 for the damages to the dwelling and contents.

7.  An 80-year-old homeowner took an indirect hit to her home from a tornado and her roof covering was extensively damaged.  The insurance company insisted, in spite of the objection of several contractors she consulted, that the roof could be inexpensively repaired instead of replaced.  Knowing that Missouri law forbids exterior contractors from representing the homeowner, the insurance company simply ignored the contractors’ objections and logical explanations.

The home owner’s attorney and her contractor contacted me for help.

After negotiating with the insurance company and exercising certain rights within the policy that the homeowner did not know she had, the insurance company paid to replace the entire roof.

8.  A homeowner with extra coverage in his policy (that pays extra costs that are required to comply with codes and ordinances) was entitled to a total roof tear off and replacement … but the insurance adjuster arranged for an “engineer” to interpret that the city’s code did not apply to the conditions of his roof.  Instead, they denied his claim and paid him nothing.  His roofing contractor suggested to him that he contact me.

After my investigation, the insurance company’s adjuster’s “engineer” was discovered to be NOT a licensed professional engineer, but merely a roofing consultant hired by the insurance company who was being misrepresented by them as an “engineer”.

We quickly turned their $0.00 (after deductible) roof repair settlement offer into a large settlement covering the full cost of removing a layer of slate tiles, two layers of asphalt shingles and adding a cover of brand new shingles — exceeding $12,000.00.

9.  A storm blew many of his shingles from his roof but, when he filed his claim with his insurance company, the homeowner was told that the insurer would only pay for half of his roof due to what they considered to be “poor workmanship” on the part of the roofer that installed it.  The insurance company hired their own engineer to support their denial.

The homeowner contacted his attorney who referred him to me.

When my negotiations with the insurance company concluded, the homeowner received an additional $14,803.00 to replace his entire roof.

10.  High winds had damaged the vinyl siding on only one side of a home that the insurance company agreed to replace, but the style and color of siding were no longer manufactured.  In order for the siding on all sides of his home to match, the homeowner paid to have the siding on all sides replaced.

His insurance company refused to pay for more than the side that had been damaged and, at the suggestion of his exterior contractor, the homeowner contacted me to represent him with his claim.

After my negotiations with his insurance company, they agreed to pay the homeowner an additional amount (exceeding $13,000) to cover the new siding.

11.  On a cold December day last year, a broken water main flooded the street … and then the basement … of a homeowner in North St. Louis County.  The water company offered only a couple of hundred dollars (and, according to the homeowner, tricked her into signing a release) and her insurance company denied the claim.

With thousands of dollars in damage and mold beginning to take over the living space and after several months of getting no cooperation from her insurance company, the homeowner called me for assistance and hired me to represent her with her claim.

After my negotiations with her insurance company, they agreed to pay over $19,000.00 to the homeowner to repair the damage to the basement.

12.  A commercial building suffered damage during a storm that included the destruction of the heating and cooling system. The insurance company looked the other way while a rogue adjuster acted improperly and delayed processing and payment of the claim.

The building owner asked his contractor for assistance and the adjuster added further delay by attempting to intimidate the insured and his contractor by implying that they were acting “fraudulently” and by making other baseless accusations and threats.  

They hired me to negotiate their claim and within two weeks, the insurance company found that it would be in their interest to stop looking the other way … they pulled the case from the adjuster that was acting improperly … and provided a check for $25,990.00 to pay for the damaged heating and cooling system.

 

Out of many claims that were worked and are still working for this year, these are the most eye-catching.

Contact me at 314-803-2167 for a free evaluation of your claim.

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