» HELP! Insurance screwing me over

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  Post subject: HELP! Insurance screwing me over
PostPosted: Thu Jul 21, 2011 9:14 pm 
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Hello. So here's the story. We had some bad storms abut a week ago and our home sustained damage and after hearing something hit the roof, it developed a leak. We had the insurance adjuster come out and they are replacing some siding, gutters, drywall in the kitchen where the leak came thru but NOT THE ROOF. There is no visible damage to the outside of the roof but if you look in the attic and you can see water damage on the plywood as well where the plywood has gotten soft and has started to splinter from being stepped on from the outside. I have State Farm Insurance and I called my agent and he gave me a number to a contractor. I called the contractor and he is on his way out tomorrow to have a look. So what gives? Am I getting the run around from my insurance company? Thanks so much!


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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Fri Jul 22, 2011 2:11 am 
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Your decking is splintered from being walked on?,,How many people have walked your roof to cause splintering since the storm?

Chances are your adjuster has located point of entry and is giving you some money for a repair.

If the adjuster has deemed the roof repairable then if his findings are truly accurate then that is what you get.On the other hand State Farm has its own preferred contractors.But in the end its up to you about who will perform your repairs.

Will something hitting your roof in one specific area justify a complete replacement ??,,Most likely not.A certain percentage of the entire roof has to contain some type of weather related damage,whether it be wind,hail or flying debris.And for an entire slope replacement it to has to contain enough damage to warrant the entire slope to be replaced.

When you say something hit your roof do you know what it was that struck your roof?? My experiences with deck replacement coverage is,it has to be a direct result of a storm related cause.

I would wait to see the findings of the preferred vendor before you act directly against the insurance company.In the mean time if you have a contractor you trust who is knowledgeable with storm damage I would include him/her in this meeting.

IMO State Farm is a poor excuse of an insurance company.They are notorious for sticking it to the insured.Just remember always have a second opinion for your own piece of mind.Good luck.

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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Fri Jul 22, 2011 2:21 am 
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I was a property adjuster for 15 years, and have handled claims similar to yours on many occasions.
Insurance policies pay for sudden and accidental damage. They do not pay for maintenance, normal wear and tear, rot, repeated leakage, etc.
You mentioned water damage to drywall. If that was caused by a single occurrence, it is sudden and accidental, and should be covered, assuming you have an all risk policy.
You mentioned that SF is covering siding and gutters; I am assuming this this is due to hail damage, although you didn't say. Hail damage is sudden and accidental, and is covered by insurance. The fact that the siding was damaged does not necessarily mean that the roof was damaged. Your roofer should inspect it.
You mentioned "water damage" to the plywood roof decking in the form of stains, and soft wood. Stains in the attic, in and of themselves, are typically not considered "damage" as the damage is cosmetic only, and is in an area not normally visible, and is therefore not generally covered. Soft wood suggests a long term leak, rather than a single occurrence, and is therefore not covered. If it was damaged further by being stepped on, some ins. companies may make an exception.
Unless the roof is damaged by hail or wind, SF won't pay for a replacement. The simple fact that it is leaking does not mean it was damaged by hail or wind. In fact, hail rarely causes a roof to leak. If the roof was sufficiently damaged by wind enough to cause a leak and necessitate replacement, the damage would be evident. Based on your description, it sounds like the roof has been leaking for quite some time, and is not related to the storm.
My only suggestion is that, if you are still dissatisfied, ask SF to send a different adjuster to reinspect the roof for hail damage. It is entirely possible for minor hail damage to be missed on the first inspection. If you have a competent roofer, he or she should inspect it with your adjuster.


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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Sat Jul 23, 2011 4:56 pm 
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Charlie D wrote:
My only suggestion is that, if you are still dissatisfied, ask SF to send a different adjuster to reinspect the roof for hail damage. It is entirely possible for minor hail damage to be missed on the first inspection. If you have a competent roofer, he or she should inspect it with your adjuster.


Spriggz,

The adjuster is trying to blame the leak on exixsting wear/tear, neglect, improper installation,etc. They are suppose to give you the benefit of a doubt anytime it may, or may not be caused from a storm, but some do not look at it that way....

Now if it was an existing leak (before the storm) as Charlie said...insurance simply does not cover it....often most of the questions they ask before and during an adjustment is to determine things like that.

As Roofmaster said get a couple more opinions before asking for that second adjustment, don't rely solely on the opinion of the "approved contractor" they send you...often they send those guys out to give a favorable opinion for ins. co. and not you.

Have a couple licensed and reputable roofers in your area take a look at it and if their opinion differs than your ins. co's estimation request a second adjustment and show their findings to your adjuster.


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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Sat Jul 23, 2011 5:51 pm 
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I recommend that the first thing you do is talk with a contractor not referred to you by your ins co. If an object hit the roof and started a leak there, why/how did siding and gutters also get damaged?

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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Sat Jul 30, 2011 3:45 am 
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A State Farm prefered contractor can only come out if you agree to it,they can not force them on you. State farm approached me about being a prefered contractor last year and i passed as it only benefits State Farm.At first i was impressed that they offered made me the offer but after meeting and learning the terms of the agreement i passed.

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johne (Sat Jul 30, 2011 5:28 am)
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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Sat Jul 30, 2011 4:13 am 
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I disagree with Robert F that preferred venders only benefit the insurance companies.
How is that getting dozens if not hundreds of jobs/contracts per year free, without any advertisements or salesman only benefiting the insurance companies?
Sure, you have to buy your materials at a specific store, but I think that getting guaranteed contracts with the invoices paid and paid quickly. More then makes up for the inconvenience of buying materials at a specific store.
BTW... the terms of the agreement are negotiable.


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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Sat Jul 30, 2011 7:17 am 
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828; How is that getting dozens if not hundreds of jobs/contracts per year free, without any advertisements or salesman only benefiting the insurance companies?

There are No free lunches and it ain’t cheap. I think deep down you know…SF is just playing you for a Fool – just like a welfare recipient, it’s easier to be wholly dependent on the State(Farm in this case). The price is your freedom, dignity, pride and happiness...short-term gain for long-term pain - it's your call, but SF's laughing all the way to the bank.

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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Sat Jul 30, 2011 4:03 pm 
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johne wrote:
828; How is that getting dozens if not hundreds of jobs/contracts per year free, without any advertisements or salesman only benefiting the insurance companies?

There are No free lunches and it ain’t cheap. I think deep down you know…SF is just playing you for a Fool – just like a welfare recipient, it’s easier to be wholly dependent on the State(Farm in this case). The price is your freedom, dignity, pride and happiness...short-term gain for long-term pain - it's your call, but SF's laughing all the way to the bank.



We're not a preferred vendor for any insurance company although we've been asked by numerous Adjusters to apply. But you're stroking with a pretty wide brush with those statements. I have no idea what the requirements are for a SF preferred vendor but if it can be done at profitable margins, I have no idea why that would cost someone their freedom, dignity, pride and happiness. However, being broke has a profound impact on freedom, dignity, pride and happiness. Well, perhaps not freedom, you are free to starve.


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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Sat Jul 30, 2011 5:05 pm 
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I have been told by 2 contractors who declined to be "preferred vendors" that you must agree to certain conditions.

The one that struck me as a deal breaker is that you agree not to fight their adjusters decisions should they turn down the claim. No appraisal process, etc. Im sure the policy holder can choose to fight the insurance carrier, but the contractor must not be part of the process. Sounds nuts.

If that is true(and I have not verified it), I would never do it. Youre basicially are selling out your customer for some leads. Better to get referrals and to work for new leads.

The one I did like is you agree not to cover any deductable, ever. Naturally, most roofers cant handle that one and, frankly, most homeowners would not use you since there are plenty of non-preferred contractors who will.

That being said, State Farm has been fair with me and their policy holders at least 90% of the time.

Just my opinion.


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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Sat Jul 30, 2011 5:14 pm 
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As State Farm is no longer paying for drip edge or roof vents unless they are damaged and you have to fight for O&PA on every claim that qualifys, i see no benefit in being a prefered vendor.They will only pay material cost, if you buy material in bulk at a discount they will only pay you the discounted amount. They only recommend you to the customer,they dont have to use you. In a cat situtation they do not use prefered venders, they will dictate pricing with thier minupulated version of exitimate. So tell me why i would want to be a prefered vendor? Maybe i could change my name to state Farm Roofing? State Farm has hired the same firm, Allstate hired in the 90s to increase thier profit margins and that is by denying,delaying and stalling claims till the insured becomes tired of fighting and gives up.On average it has taken 90 days to settle hail claims in the New Orleans area and i have hired a pa to sit on the phone with them and submit estimates,supplementals,photos etc.

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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Sat Jul 30, 2011 5:20 pm 
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Pete that is true,they will tell you what to do and how.And lets face it adjusters are not roofers and they miss items on the claims by accident or intentionally and i would not aggree to be thier contractor of choice it is a one way street and ive found state farm to be combative and decietfull in the claims process.As ive stated previously ive contacted the state insurance commisioners office to get results.

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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Sat Jul 30, 2011 5:55 pm 
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Robert F wrote:
As State Farm is no longer paying for drip edge or roof vents unless they are damaged and you have to fight for O&PA on every claim that qualifys, i see no benefit in being a prefered vendor.They will only pay material cost, if you buy material in bulk at a discount they will only pay you the discounted amount. They only recommend you to the customer,they dont have to use you. In a cat situtation they do not use prefered venders, they will dictate pricing with thier minupulated version of exitimate. So tell me why i would want to be a prefered vendor? Maybe i could change my name to state Farm Roofing? State Farm has hired the same firm, Allstate hired in the 90s to increase thier profit margins and that is by denying,delaying and stalling claims till the insured becomes tired of fighting and gives up.On average it has taken 90 days to settle hail claims in the New Orleans area and i have hired a pa to sit on the phone with them and submit estimates,supplementals,photos etc.



I have seen no issue whatsoever getting paid for these items, at least to a degree. You simply have to point out that drip edge is installed on top of the felt and therefore must be removed in order to provide a complete roof replacement. On vents, you go for the detach & reset which is within a couple of dollars of the remove & replace price. For example, detach & reset for a power vent is around $90 depending upon the market. Roof vent, detach & reset is $29 to $45 depending on the market. You saying you can't put on a new turtle or low profile vent for $29?

I supplemented multiple roofs with SF CAT the past couple of weeks. The end result in each case was $275 to $295 per square for 3 tab roof replacements. Each one took less than 10 minutes of phone time reviewing my supplemental estimate with the Claims Representative.

Don't be confused, we don't win 100% or even 90% every single time. However, when we submit a well prepared estimate with picture evidence supporting our request, we get paid for it the vast majority of the time. Do I like that we have to do this? Absolutely not. But I'm calling the same people everyone else is so I really have to wonder why we get cooperation when others do not?????

Now let me give you the other side of the coin. We had a Customer who used us to get their roof claim approved and then went with another contractor to do a roof over. The HO was stupid enough to turn in their invoice for recoverable depreciation listing us as the contractor. The Adjuster called us to question it because they turned in a supplement for 6 additional squares. LOL So they did a shingle over and filed for the full recoverable depreciation plus a supplement for 6 squares which I absolutely guarantee you was bogus. I am confident this isn't an isolated case, the insurance companies see this crap hundreds and thousands of times per day. Any wonder why they require solid documentation on the supplements in order to get them approved?

What is a shame is all the CAT Adjusters purposefully omitting items from the scope requiring the contractor to submit a supplement for items that should be paid to begin with. Why do you think they do that? Could it be because 75% of the moronic contractors out there will gladly take that job, build it for that amount and never say a word about a supplement? What do you think would happen if every contractor started pushing and supplementing for items that should be on each scope of loss?

Remember this thread over in Construction & Technique? After oldmanroofing turned in the documents I sent him, he got paid for the 9 squares. xactimate-adjusters-eagleview-t11532.html

I'm no big fan of the insurance companies by any means. But I also would like to think I'm intelligent enough to be objective about what is going on. Frankly, I'm way more frustrated with the vast majority of contractors that are crooked, unethical or incompetent, or all 3, than I am about the insurance companies. If even half of the contractors would operate their business in a competent manner with integrity, we wouldn't be discussing these issues. The insurance companies are huge corporations that are very bureaucratic. Do you honestly think that every single individual working as an Adjuster, Claims Representative, Desk Adjuster, et al are immoral and corrupt to the core? They have bureaucratic rules put in place they have to follow. The vast majority of the time, if you provide them with the evidence they need to justify their decision with their manager, they will agree to do the right thing. I freaking guarantee you on a % basis, the insurance people you deal with day to day are more competent and morally sound than the contractors working the other side. Robert, by no means am I accusing you of being incompetent or immoral, I'm simply trying to put this into perspective in order that you may look at it differently and alter your approach to be more successful and get paid better.

Robert, if you would send me a PM with your email, I'll sanitize (remove claim#, HO info, etc.) one or two of our supplements to show you what has worked.


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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Sat Jul 30, 2011 10:33 pm 
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I have an allstate claim from this storm we have completed all work on the claim,the adjuster met with my estimator steep,cut up,custom home she has eagleview estimate it they estimate the nieghbors house so she tells us to go ahead and repair the damages and have eagleview estimate the correct house. Well we have roofed it,changed the gutters replaced aluminum patio cover it also has a canvas awning that that prevented us from replacing the roof in that area.So we had the awning company out to remove and reset the awning,now weve been complete for over two months this adjuster refuse to deal with us now and is saying she wants to only deal with the insured.I run a honest company and have been in business for many years and have a good rep.We know the claims process well i roof all over southern Louisana and am well versed in working insurance claims many hurricanes and hail storms.I know for a fact that state farm has adopted the same approach to claims as allstate,after hurricane Gustav every claim i went on for Allstate the adjustment was way off.Some architects were wrote up as three tabs the square footage was usually way short, vents and drip edge wernt included.
You feel the way you do,ive been dealing with both of these insurance companys on claims for years and you will not change my opinion on them.

Im sure theres plenty of crooked contractors out there and plenty of inexperienced contractors we are not one of them and they irrelvent to my situtation. I am running a business that requires me to deal with these insurance companys, i prefer to bid and let the homeowner fight it out with them but that is not possible nowadays with the influx of storm chasers and thier illegal alien crews. So we sign them up and deal with the insurance companys as they are denying legitmate damages on a lot of hail claims. This actually benefits us people learn we can get them settled,i could go on for days about this.

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  Post subject: Re: HELP! Insurance screwing me over
PostPosted: Sat Jul 30, 2011 10:35 pm 
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Every estimate that we submit is written up on exatimate and photos are included,were not the problem.So do you consider paying for power vent cover instead of replacing the whole power making the insured whole?
I do not and weve fought every one of those and won,not replacing heater jacks and caps that is not the right way to change a roof, vents get hit by shovels removing the shingles ive seen leaky vents that were caused by shovel damage and we sent every piece od documentation we could google proving that drip edge is required to effectively change a roof on the gulf coast.We adopted the high wind building code state wide in 2007 because the insurance industry told our state legistlators they would pull out of Louisiana if they didnt.State farm has made no secret of the desire to drop homeowners in Louisiana coastal region, we have an insurance company formed by the state called citzens and all the insurance companys dropped thier wind coverage so they pick it up and every resident pays extra on thier policys to supplement this insurance company.What i find ironic is forcing us to adopt this code then trying to circumvent the code in claims.

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