The Hartford Insurance denial

I just get into the situation that the insurance adjuster denied to pay for the full roof replacement, just pay for repair (the roof is totaled). When i call in to request for re-inspection, even thought I already email them all the pictures showing the roof has hail damages, they asked if i am a public adjuster to begin with. As i know of, here in Texas, we do not need to have license to talk to them on the residential claim. The property is in Dallas, TX. Have anyone of you run into that situation and how do you handle it.

Thank for sharing

can i have your number? you can email me at er.contractings@gmail.com

Thank you so much

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Why would you call in if you’re the Contractor? No wonder the Adjuster asked if you are a PA, you have no business calling in for the second inspection. Provide the HO with an estimate, a professional inspection report and an organized gallery of damage photos to send in. That will get you the second inspection.

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I am sorry to read what you are in. Insurance companies are notoriously difficult and cagey to work with when a claim is presented to them. If I were in your situation, I would review the original copy of a contract agreement I signed with them them. If a claim is to be filed, does it allows the use independent adjuster at the insurances own expense? The option to use own independent adjuster may offer a different outcome for you.

Good luck

I did that before i call in and they keep saying it is normal tear and wear not hail damage and denied the claim to the HO and refuse to do second inspection.

With the revision of the UPPA law in Texas by the passing of House Bill 2103 in Sep 2019, the insurance companies do not have to talk to contractors about anything if they do not want to. The only person(s) who can legally speak about a claim is the insured and a Public Adjuster if they have a letter of representation. Contractors cannot legally have any type of letter of representation which claims they have the insured’s representative for a claim. The residential arena has become the battleground for the insurance industry the past few years. Insurance companies, for now, will continue to speak with contractors about the claims because they know that in the end it saves them the most money to not have a public adjuster involved and also to try and keep the claim from going to the appraisal process since that is on average a big loss for the insurance companies here in Texas. I advise contractors to accept this reality sooner rather than later to save you in many headaches in the near future. We are also a Public Adjusting firm here in the DFW area. I hope that APIA can get this resolved for you. We are all on the same team here.

If Contractors utilize the Homeowners properly and understand what they can say, and cannot, they shouldn’t need to use appraisal or a PA for most jobs. The biggest problem Texas has is the hoards of Contractors out there eating $1000 to $4000 deductibles and gladly taking the jobs. How can they keep a straight face and tell the IC they’re underpaying the job when those Contractors that can’t sell or run a business properly are giving their profits away by eating deductibles and giving other discounts?

The primary problem isn’t the IC’s. It is the 50% plus of the Contractors that have ZERO clue how to properly work insurance jobs. There are some top notch PA’s and Appraisers that do a great job. Unfortunately, far too many of both can’t find their ass with both hands.

I never wanna be part of those contractors. I was trying really hard to learn from experienced contractors to do it in a right way.

In that particular situation, I told the HO email the adjuster our estimate with pictures and request for the second inspection. They responded, the pictures they had are similar with my picture and it is normal tear and wear not a hail damage, therefore they again denied the claim. Then, i call in and try figure out why they keep saying it is a normal tear and wear. Their answer was, they only discus the repair with contractor, not type of the damages. They only discus this with PA licensed and they wont response to the contractor unless the contractor has PA license.

However, after all I have the owner call in back in and request for another adjuster due to unreasonable denial on the claim. Then, they finally call back to set up a second inspection.

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Not sure if you (Aunthentic_Dad) are in Texas but the state passed HB 2102 which now mandates homeowners pay their deductible with the law putting the responsibility and consequences onto the contractor. Now the “honest” contractor has a moral dilemma. One one hand they can obey the law and sleep better at night, or on the other hand they can continue to “eat” deductibles for fear they will lose more contracts and forfeit their morals. The state is making efforts to get the insurance industry closer to how it is supposed to be. So now those “honest” contractors who are going to make the insured’s pay their full deductible need to stand up against the ones who are still “eating” them. It is really up to the good contractors to change it to the way they want, which is for everyone to abide by the laws in place. TDI has ways that you can turn in those contractors who are still breaking the law which will eventually change the Texas industry as a whole. On that same moral path though Texas has also said that contractors cannot legally play the part of a PA. Those same “honest” contractors also now have to rectify violating that law with themselves too. So the only moraly honest ones out there will not only make homeowners pay the full deductible but they will also not deal with the insurance companies either. You can’t complain about others who break the deductible law if you continue to break the UPPA law.

They lied to you about discussing anything with the contractor if the contractor has a PA license. It is a trap. It is illegal for anyone to be a PA and contractor on the same job in the state of Texas. You can look at the Texas insurance code in the public adjuster section as follows.
Sec. 4102.158. CONFLICTS OF INTEREST PROHIBITED. (a) A license holder may not:

(1) participate directly or indirectly in the reconstruction, repair, or restoration of damaged property that is the subject of a claim adjusted by the license holder; or

I think it is baffling how many contractors, especially new ones such as yourself, just refuse to make life easier for themselves. The contractor is not supposed to be an insurance expert. You need to be a roofing expert, you do not have the time to become an insurance expert. You are also losing money by trying to play the part of a public adjuster. If you want to make more money and do less work then have the homeowner hire a public adjuster on every job. Take this one for your example. the time you spent on it you could have advised the homeowner to follow the law and obtain the services of a public adjuster or appraiser. You have less headache and more time to go out and get another contract. When the PA or appraiser are done then you also get that job and make more money on it than you have on any other job. It amazes me how many contractors fight so hard to make less money all because they think they can do it all themselves. If you find a good PA or appraiser then you actually do less work on those jobs and make much more money.

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I am not but am quite familiar with the BS that goes on in Texas. The laws there are essentially the same everywhere. The problem is the size of the market and the rampant abuse that occurs there. The laws can be followed and supplementing performed effectively if executed properly. I’ve been doing this for 11 years with offices in 3 states. We’ve used appraisal or a PA less than 10 times total over that period of time. Haven’t needed to. And most of those times we did use appraisal or a PA, it didn’t turn out nearly as well as expected and delayed the jobs a ton. And the PA’s/Appraisers we used were high profile and supposedly very good at what they do.