by Guest » Thu Jul 14, 2011 07:02 pm
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?
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?
Posted: Tue Jul 26, 2011 05:07 am Post Subject: Insurance Shooting Down their own adjusters
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 !!!
Posted: Mon Aug 01, 2011 07:50 pm Post Subject:
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.
Posted: Tue Aug 02, 2011 07:47 am Post Subject: Tornado Damage and Home Owner Claims not being fairly settle
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
Posted: Tue Aug 02, 2011 08:44 pm Post Subject:
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.
Posted: Wed Aug 17, 2011 06:39 pm Post Subject:
So we called the S.E. early this week who said they had amended the report (to say what we have no idea) and submitted it back up to the insurance company. I called the ins co and they stated they had not received the report, but it could just be held up. I'm OK with this, if it takes a day or so, by all means, I don't want to rush anyone.
Depending on what the report says, either the adjustor will be sent back out. If we were still unhappy at that point it would go to arbitration (according to our claims handler). Seems the appraisal clause would come first, but there might be a certain advantage to not mentioning this to us. As anyone who visits the property believes it's a loss. Anyway there was some weirdness to the conversation that I love to hear more about if anyone has info.
The first S.E. report we received had no dollar amount attached to any of the points it mentioned. However our claims handler mentioned that it did. I think she must be mistaken right? The insurance company gets the report and their internal engineers assign the dollar amount not the outside engineer, correct? Then the adjustor writes up the claim and it has to jive with this number (in our case it did not...multiple times). I guess what I'm asking is who assigns a dollar amount to this report? I know the adjustor is the one who actually works up the bid, but there must be some internal amount that dictates where the adjustor's numbers should be. Is this number decided by the outside engineering firm, or within the ins co based on the report?
Posted: Wed Aug 17, 2011 06:55 pm Post Subject:
I think this post goes to another thread that you already started.
If I recall the situation correctly the problem is that an independent appraiser that the insurance company sent out came up with certain damages and the insurance company disagreed.
The independent appraiser probably should not have given you any information as usually they don't have the authority to determine or explain coverage. They are only there to write up a report for the insurance company. I think part of the "problem" is that the appraiser went over some information with you. The appraisers I hire I specifically tell not to go over anything (as the carrier that I work for has unique policies).
The appraiser would submit his/her report to the insurance company and this report would have dollar amounts. But then the adjuster needs to review the damages and determine what is covered under the policy and to what extent. The appraiser might need to work up new figures based on this. Ultimately its the insurance company that determines the amount payable under the policy.
Posted: Wed Aug 17, 2011 07:48 pm Post Subject:
No, I think you might be confusing my post with another. We haven't invoked our appraisal clause yet. No appraiser has visited our home.
Posted: Wed Aug 17, 2011 08:00 pm Post Subject:
I don't know why but this looked like a new thread. Its been a long week.
Who is "SE"? I though this was the appraiser that came out to look at the property.
Posted: Wed Aug 17, 2011 08:40 pm Post Subject:
Ha, sorry I'm getting tired of typing it out, SE = structural engineer.
The last visit we had was from a SE we hired. He stated that the original SE was spot on, but he missed a major issue dealing with the structural integrity of the home. Unless this was addressed, the home could not be deem "safe".
I've really tried to keep this "anonymous" and be vague on a few things for a couple of reasons. First I don't want to turn this into a bashing thread about my ins co. I'm here for some advice and suggestions, not to vent about my ins co. Secondly I don't want to be identifiable, it just seems best to keep specifics under wraps until this is resolved. However, I'm finding myself in a position where I don't know if I can really relay the problem, without discussing the specifics. Perhaps I'm being over cautious at the cost of not doing a good job of describing the problem.
Posted: Tue Aug 30, 2011 06:41 pm Post Subject:
Well it appears the original engineer will not be making any drastic changes to his report. That said, the co is still sending out another adjustor, I have no clue why. Long story short, I feel we have exhausted our options. We will be hiring an lawyer, invoking our appraisal clause, or hiring a PA. Not sure which yet, but we need to pass the job on, we just can't keep this up. It's taken too much of a toll on our lives. Sure would be nice if they would listen to their adjustors and our contractor and simply pay what they suggest.
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