4 Case Studies Of 4 Separate Hail Caims With Different Insua


#1

**[size=150]4 Case Studies Of 4 Separate Hail Caims With Different Insuarance Companies[/size] **

A contracting company has a contract with the home owner, not with the insurance company.

Now, to be more professional and assist the home owner in getting their full amount payable that they have been paying premiums for with their Home Owners Insurance Contract, I will go above and beyond the call of duty expected of me by any home owner.

I must be running into more insurance work recently because I have been focusing on it a lot more, since all those Storm Troopers, errrr, I mean Storm Chasers came into town.

4 Current Case Studies:

4 customers with 4 different insurance company’s:

By the way, none of these clients initially called in requesting estimates for insurable damages. They were totally unaware that their insurance company’s would cover shingle and siding damage, since they were not in the center of the Storm Chaser location where everyone is getting all new work done.

All 4 houses are in near proximity to each other, only separated by about 1 mile from the farthest 2 homes. 2 homes are right next door to each other, but with different insurance company’s.

By the way, the Storm Chasers have not invaded these neighborhoods yet, so there is NO NEIGHBOR-ITIS that has infected the attitude of the claimants yet.

Hartford:
1 with Hartford and the customers did everything I told them to do when making their claim call. They scheduled and required that the adjuster contact me first to meet him at the home. The adjuster went their without calling me, yet still was agreeable to the claim. The only difference is, that since I had a signed contract with the home owner for Roofing for the house, roofing for the garage, gutters for the house and siding for the house.
This adjuster says that they do have records that a recent hail storm causing damage has occurred.
Totals = 1,970 sq ft of 1 layer T.O on walk on pitch, roof and replace basic 3-tabs. 82 feet of gutter and 1 of 1 story DS and 1 of 2 story DS and 1,581 sq ft of siding only, with no deductions made for window and door openings.

His figures for that 1 layer tear-off and related work maxed out at around 12,432.61 After reviewing his paperwork and catching 5 very simple roof measurements that were off and a shortage on the siding and that there were gutter guard screening in the gutters, the amount is now at 17,483.00 which just so happens to be my signed contract price.

Why didn’t the adjuster have that required additional $ 5,000.00 in the adjustment originally?

Farmers:
1 with Farmers and the roof was so severely deteriorated from improper ventilation, I told the home owner not to even try to claim that and only claim the siding which had been visibly affected.
Check written on the spot for the siding because the adjuster confirmed his appointment with me and we went over the job.
1,637 sq ft of siding R & R = $ 9,342.14

State Farm:
1 with State Farm and adjuster met with me on his 2nd attempt due to rain, on a Sunday afternoon.
1 layer Tear-Off on a Walk On pitch with no accessories at all.
2,483 sq ft of roofing with basic 3-tabs = 7,309.00 I had a signed contract with the home owner for 7,674.00 and the check written out on the spot after the deductible was for $ 7,309.00
His value for all line items were listed as “Per Bid Item”

AllState:
1 with AllState. This is the next door neighbor to the “Farmers” client. This home owner saw that I had pointed out the hail damage to his neighbors siding and that the adjuster came out and agreed and paid for it.
So, Mr. Sharpie HO figures why does he have to have a signed contract with me first and have me meet with his adjuster.
1st AllState adjuster says that their is definite hail damage, but that he has no reports of recent hail, so,
Denied.
Mr. Sharpie HO asks his neighbor what he should do and the neighbor remembered what I had told him about requesting a 2nd adjuster to come out and review the damage.
2nd adjuster comes out and says their is definite hail damage but that he has no report of hail in the area recently, so,
Denied.

By the way, the photos submitted by the AllState Adjusters, or at least the ones I saw at the Home Owners house tonight, conveniently did not have any pictures on any of the 4 sides that revealed the dents and the dings on the aluminum siding. I went around and saw significant hail damage on 3 of the 4 sides.

**Wait A Minute!!! **

3 other Insurance Company’s that did their adjusting work had recent and large enough hail damage on file to know that the hail damage most certainly was from a recent event.

Why does Hartford, State Farm and Farmers all have records indicating that a recent hail damage storm was substantial enough to accept their proper liability for making their customers whole again and paying for the proper remediation work, but AllState in their All-Knowing methods deems otherwise, with not only one adjuster, but 2 separate adjusters for the next door neighbor who had Farmers Insurance?

Could 3 individual Cat-Adjusters from Hartford, State Farm and Farmers and their weather reports be wrong?

From AllStates perspective, all 3 of these other company’s Must be wrong, because they have no records of any recent hail, therefor the right way to take care of their customers is to deny them coverage.

Although I started off, trying to keep my sarcasm to the tactics of one company out of the written post here, the ludicrousness of how they get away with treating their customers in such a fashion goes beyond disbelief.

There very well are adjusters that work for that company who have integrity and a sense of fair dealings and being truthful with their contracted clients, but it seems as if they must be few and far between. I admire the guy who can take a stand for ethics and integrity, instead of spewing the company line. At what point would the obvious facts be enough to draw attention to oneself. Would an adjuster who was trying to be more truthful and faithful to the clients soon have their position diminished or terminated? I would hate to be in those shoes, knowing that I Had to Cheat and Lie on the company’s behalf, because it seems to be their policy around here.

The only thing that is preserving their image of integrity, is that most Home Owners and Most Local Contractors do not know that they are being taken advantage of. Ignorance is bliss, So You Remain Thinking You Are In Good Hands As Long As You Are Ignorant Of Your Contractual Rights That They Will Not Enforce For You.

Ed


#2

Ed, Allstate is not longer the good hands people, they are the “We got you by the Balls” people. I honestly don’t know how some Allstate adjuster sleep at night but I have a clue. Their adjuster must be getting a much higher fee scedule then most.


#3

That seems to be the point I got from the dealings with 4 different insurance company’s all working in the same area, with 3 of them acknowledging the recent hail damage, while AllState blatantly lied, from not only one adjuster, but with a 2nd one called out for a re-inspect.

If it had only been one adjuster, it could be chalked up to human error.

With 2 separate adjusters spewing the same arrogant spiels, most assuredly per company policy, it reveals the truth so much more dramatically about AllSnakes Integrity, or, should I say, Lack Of Integrity.

Ed


#4

Not defending Allstate, but, you may have a date of loss type issue.

You indicated that it was a “recent” hail storm. If the Allstate policyholder had recently switched their insurance from a prior company over to Allstate after the date of the “recent” storm, then, they are right in their position.

So, the real question that everyone should be asking is “What is the date of loss of this recent storm?” Typically, one can very easily identify hail episodes through the national weather service or other online services.

The policyholder simply needs to demonstrate that the hailstorm in question occurred in their policy period and caused the damage.


#5

Ed,

To get a re-inspection do you have to fax the agent or adjusters office a estimate? This is the norm here in MN. They must figure it better have some damage for a contractor to take the time to measure and write an estimate.


#6

These were not Date Of Loss problems, as all of these home owners were with the same insurance company for many years each.

As far as the re-inspects, I just tell the HO to make the call and request and ensure to get the new adjusters cell phone # and insist that they make an appointment withme to coordinate a time that we agree to.

Ed


#7

Ed:

By what you have typed, there is most definitely a date of loss issue. You wrote that both Allstate adjusters acknowledged the “hail” damage to the siding.

That being said, the only leg that they can stand on is that the loss happenned outside of their policy with this homeowner.

Further, if they are denying the claim, they are obligated by law to state the reason for their denial in writing and provide that to the homeowner.

Something seems to be missing here.


#8

I will follow up on the exact “Written Details” as the customer has a new re-inspect scheduled for this coming Saturday morning.

Ed


#9

Hello, I am new to the site.

Ed,

I chime in only because you mentioned siding.

Have/are you charging a separate amount for caulking around windows,doors, etc… when doing a siding bid?

In exactimate, the material breakdown does not include caulk. It therefore would not be accounted for in the labor portion of that item either. I spoke to support for exactimate and they said that caulking should be entered as a separate line item if it is a part of the job.

Exactimate pays $2.26 per linear foot here in MN. That means every 5’x5’ window is worth about $68.00 with O & P!

It is my understanding that caulking around doors and windows IS a code issue.

Anyone have insight into this?

PS Doug, Any word on Hampton Yet? We start Ackerman Terrace tomorrow. Do we owe you for the fascia?


#10

Good thing to know. regarding the caulking price per lineal foot around windows and doors.

Thank You.

Regarding the Farmers job that had the re-inspect on Saturday, where the Home Owners got turned town 3 times already when they handled the claim themselves.

When the adjuster met with me, he totaled the roof for the HO’s, which I don’t understand, because it was, in my opinion, just deteriorated at 19 years of age and had No roof top ventilation, except for 2 very smal triangle gable vents at the opposing sides.

But, the legitimate portion of the claim, where the siding had hail dings all over it, he denied, because the electric meter hard steel case has no dings. Go Figure.

The home owners are paying me for the roof and the siding anyways, so it shouldn’t matter, but I just don’t get it. I will accept it, if they want to, but personally, I hope they challenge the siding denial. They rightfully should.

Ed


#11

While I’m not a siding guy (i.e. no window experience, etc), it seems odd to me that they would line item the caulk.

When I do a roof, I don’t get a line item for plastic caps, tin tabs, staples or nails… so?

My .02 cents, anyhow.


#12

Xactimate and Simsol line item every detail. Thats where they get the Home Owners for paying for Less than a full and qualified scope of work.

Ed


#13

[quote=“ed the roofer”]Good thing to know. regarding the caulking price per lineal foot around windows and doors.

Thank You.

Regarding the Farmers job that had the re-inspect on Saturday, where the Home Owners got turned town 3 times already when they handled the claim themselves.

When the adjuster met with me, he totaled the roof for the HO’s, which I don’t understand, because it was, in my opinion, just deteriorated at 19 years of age and had No roof top ventilation, except for 2 very smal triangle gable vents at the opposing sides.

But, the legitimate portion of the claim, where the siding had hail dings all over it, he denied, because the electric meter hard steel case has no dings. Go Figure.

The home owners are paying me for the roof and the siding anyways, so it shouldn’t matter, but I just don’t get it. I will accept it, if they want to, but personally, I hope they challenge the siding denial. They rightfully should.

Ed[/quote]

Typically, isn’t there j-channel around the window and door trim?

Regarding code, if the caulk already exists and is in bad shape, then, the insurance companies are going to invoke wear and tear, maintenance etc. If it doesn’t exist, then, you’ll find that may argue improper construction.

Howver,you’re most likely not going to find any consistency as some adjusters will and some won’t pay. If the caulk doesn’t exist AND the customer has code upgrade coverage, then, you may have something there.

I’d suggest having a written copy of the local code


#14

[quote=“ed the roofer”]
Regarding the Farmers job that had the re-inspect on Saturday, where the Home Owners got turned town 3 times already when they handled the claim themselves.

When the adjuster met with me, he totaled the roof for the HO’s, which I don’t understand, because it was, in my opinion, just deteriorated at 19 years of age and had No roof top ventilation, except for 2 very smal triangle gable vents at the opposing sides.

But, the legitimate portion of the claim, where the siding had hail dings all over it, he denied, because the electric meter hard steel case has no dings. Go Figure.

The home owners are paying me for the roof and the siding anyways, so it shouldn’t matter, but I just don’t get it. I will accept it, if they want to, but personally, I hope they challenge the siding denial. They rightfully should.

Ed[/quote]

It’s one of those things where as an adjuster you’re damned if you do and damned if you don’t. I write this because all of the major carriers evaluate their people using customer service as one of their criteria.

When an adjuster makes any type of payment on a claim, it will usually generate a customer service survey to that customer.

If, as an adjuster, you make a payment for one part of a claim but not another … then … usually your service results aren’t pretty. Many times, you’ll find “neighboritis” has set in and people are hell bent on getting theirs. Sometimes, you’ve got a contractor who is flat out deceiving the homeowner.

Further, if you are an “independent adjuster” or a “Cat Adjuster”, many times you get paid more the higher amount of damage. I’ve done reinspections afterwards that would leave you shaking your head.

All in all, if Farmers paid for the roof, then, that’s great. If there’s legit damage to the siding, then, the door has been opened for this homeowner as all they’ve got to do is push.


#15

[quote=“jtdew”]

[quote=“ed the roofer”]
Regarding the Farmers job that had the re-inspect on Saturday, where the Home Owners got turned town 3 times already when they handled the claim themselves.

When the adjuster met with me, he totaled the roof for the HO’s, which I don’t understand, because it was, in my opinion, just deteriorated at 19 years of age and had No roof top ventilation, except for 2 very smal triangle gable vents at the opposing sides.

But, the legitimate portion of the claim, where the siding had hail dings all over it, he denied, because the electric meter hard steel case has no dings. Go Figure.

The home owners are paying me for the roof and the siding anyways, so it shouldn’t matter, but I just don’t get it. I will accept it, if they want to, but personally, I hope they challenge the siding denial. They rightfully should.

Ed[/quote]

It’s one of those things where as an adjuster you’re damned if you do and damned if you don’t. I write this because all of the major carriers evaluate their people using customer service as one of their criteria.

When an adjuster makes any type of payment on a claim, it will usually generate a customer service survey to that customer.

If, as an adjuster, you make a payment for one part of a claim but not another … then … usually your service results aren’t pretty. Many times, you’ll find “neighboritis” has set in and people are hell bent on getting theirs. Sometimes, you’ve got a contractor who is flat out deceiving the homeowner.

Further, if you are an “independent adjuster” or a “Cat Adjuster”, many times you get paid more the higher amount of damage. I’ve done reinspections afterwards that would leave you shaking your head.

All in all, if Farmers paid for the roof, then, that’s great.

If there’s legit damage to the siding, then, the door has been opened for this homeowner as all they’ve got to do is push. [/quote]

JT,

Once they have that first check in their hand with no recourse, that is what I have informed the home owners to do.

What would be the best way to get the siding evaluated?

One more inspection prior to roofing?

Inspect it after roofing work is completed, but before I start the siding job?

During the siding removal and go, OMG, Look at all of this damage discovered and save the pieces?

Ed


#16

Hello Steve and welcome to the site!!!

The fascia was paid for with the shingle load. Was going to replace it but decided it would be better to have you do it with the scaffolding set up. We did replace all the drip edge though.

The Hampton job is just waiting approval on the estimate from the insurance company. Really hope to get it as the $40K in roofing sure would be nice!

Here is some food for thought.

Two days ago we started a 38sq tear off off which had get this, wood shakes, 3-tabs, 50yr and 30yr laminates on it. The adjuster paid to replace all the shake ridge and to replace the 3 tab section. On the second meeting I couldn’t be there and the home owner said they replaced the 18/12 50yr laminate section. We had a signed contract at $16,750 to put down Landmark 40’s. I told the home owner to make me a copy of the insurance paperwork so I could try to get her the depreciation. Come to find out the second adjuster paid to replace the whole roof at $19,200! Now the question is how do I approach this situation? Should I call the insurance provider and explain the situation? Should I send an estimate to R&R to 40 year laminates? They should figure that although the insured had a full replacement policy they didn’t want to pay to upgrade the whole roof to cedar shakes. About half the roof was shakes.

BTW, the shakes had no breaks or cracks from the hail and no wind damage.


#17

JT,

Once they have that first check in their hand with no recourse, that is what I have informed the home owners to do.

What would be the best way to get the siding evaluated?

One more inspection prior to roofing?

Inspect it after roofing work is completed, but before I start the siding job?

During the siding removal and go, OMG, Look at all of this damage discovered and save the pieces?

Ed

[quote][/quote]

I would suggest to you that you or the homeowner take pictures of the siding before the roof work starts. The homeowner should contact their insurer prior to starting the roof about the siding. They may want to send something in writing to Farmers. This way, there’s no issue about the damage being related to the tear off or work in progress.

How was “obvious” damage to the siding missed? It should be all over any exposed elevations.

Sometmes one of those handheld bright spotlights comes in handy where you can shine it across the siding and it really shows the damage. Otherwise, you can always rub chalk on the siding and it will also highlight any damage.

However, I would not remove any of the siding imtil the homeowner has received in writing a definitive denial of coverage for the siding. This is required by almost all states.

If you do get to the point where you have to remove the siding to prove the damage, then, remove a limited area. Assuming that damage is present, have the homeowner call their insurer and request inspection. Once again, a written e-mail would be beneficial as it creates a paper trail.

If you’re up in Minnesota, you’re going to be running into weather issues in about another 45 days, so, I’d move forward on the roof.


#18

This adjuster stated that it was “Old” damage, even though we had a hail event last August 23rd and again, at least 2 more incidences this recent summer.

I was actually a bit appalled at his tactics trying to prove his point to the Home Owner, when we were doing a walk around on the premises.

He had the gall to look at the electrical service and meter, which are encased in hard Steel, not light aluminum siding and he stated that if there had been any hail, those items would have shown it too.

No F’n Way. That was Thick Steel encasements.

As I stated previously, I am still getting both phases of work and being paid for by the Home Owners, but this seems to be a significant injustice to them.

Even though I have nothing additional to gain, besides being considered a consumer advocate willing to fight for their cause, but not gain any additional direct profit or revenue from any future actions, I am still perplexed at the audacity of the adjuster to make such meaningless statements.

What are they trained to tell Home Owners when their is Not a liason representing them on site when they make those and other proclamations?

Ed


#19

Ed:

Frankly, there is no adjuster training done by anyone that encourages denying a legitimate claim. Insurance companies pound into us “pay what is owed … no more, no less”.

Unfortunately, you get too many people(customers, contractors and adjusters) out there with flawed logic.

The homeowner needs to establish when this hail storm occurred. That is the key to getting this resolved.

Using a compass, what side or sides of the house exhibit hail damage? Is it consistent with the direction of the storm? Which side of the house are the “steel boxes?”

It doesn’t make sense if the east side of the house is damaged when the storm came from the west. It would be the same if the adjuster is basing his conclusion on the north side of the house when the storm came from the south.

If there’s hail damage to the siding, gutters, window screeens, etc has it been painted over? Paint over damage is a dead give away of older damage.

Here’s a site that might help regarding establishing hail damage in the area.

www4.ncdc.noaa.gov/cgi-win/wwcgi … ent~Storms

It will list hail events by city or county. Perhaps it is applicable.

If I were the homewner, here areme of the points I would consider. First, how long has Farmers insured this house? How long has the customer owned the house?

This is relevant because most insurance carriers require that their agent or someone do at least an exterior inspection of the house they are insuring.

IF Farmers inspected this house when the policy was taken out and they did not notate “pre-existing” hail damage … THEN … hail damage would have to occurred since being insured with Farmers.

How long the customer has owned the house is also pertinent in that most homes are inspected before the purchase goes through. If the house has been recently purchased, then, a home inspector’s report will prove no damage at the time of purchase.

As the homeowner, how is Farmers diffrentiating old damage from “new” damage? If they’re paying for the roof, then, they are acknowledging that a “hail” event occurred.

I would politely say “it doesn’t make sense that you’ve acknowledged hail damage to the roof … then … saw hail damage to the siding but claim it is old.”

Was it windy that day of the hail incident? If I recollect, you folks had a bunch of tornadoes as well. It’s not likely, that the hail just fell straight down.

Frankly, I usually find that the siding is much more susceptible to damage than the roof.


#20

19 years they owned the home and it was new construction as they were the first family to buy on that subdivision and they have been with Farmers for the entire time, or so they told me. I am sure memories get clouded, but they are both retired and they at least would have been with Farmers for any length of duration that any recent hail storm has struck.

I viewed substantial hail on East, South and West side, with only hard to observe splattering on the North.

The Adjuster even used the term, “Splattering” to describe the hail strikes, yet stated that it was old hail. Huh?

I straight out told him, that I felt the roof was questionable at best, but the siding was a sure casualty. As you stated, the Aluminum Siding will show dings much more readily that roofing shingles.

He justified the roof, as if he did not have it replaced, there would be some sort of liability on behalf of the insurance company down the road from future leaks.

Personally, I tend to disagree with his assessment, since I do not feel that Insurance Companies are in the Destructive Weather Prediction service.

They can not possibly cover for “Future Potential Damage”, but that seems as that was his rational for covering the roof.

I Know that the siding is damaged severe enough for a replacement. Not minor, but on the heavy side of extremely moderate, just below extreme level.

Dents are visible and substantial from any perspective.

Ed