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Public Adjuster Helps Hampton, New York Homeowner Win Battle On Ice Dam & Winter Storm Damage Insurance Claim Dispute

Public Adjuster Helps Hampton, New York Homeowner Win Battle On Ice Dam & Winter Storm Damage Insurance Claim Dispute

Background:

On February 2, 2014 the owner of this upscale estate discovered massive amounts of water damage to the inside of the home.  The insured property owner promptly called his agent who in turn notified the insurance company.  The owner then called, New York Public Adjuster, Mr. Rick Tutwiler of Tutwiler & Associates Public Adjusters to manage the insurance claim.

Facts:

Immediately following the loss in February of 2014, the insured property owner reported their insurance claim, which consisted of ice damming, roof damage, and subsequent interior water damage. They were quickly informed that their insurance company would be sending out an adjuster who was assigned to help them recover from their loss and damage.  An inspection was scheduled and all parties met onsite to examine the damage and determine a proper protocol for recovery.  During the inspection, it was apparent the insurance company was leaning towards a position that the interior water damage was “pre-existing.”  Specifically, insurance companies will often use a policy term found in the Exclusions Section of the policy: “We do not cover any loss caused by wear and tear, gradual deterioration, rust, mold, rot, or warping.”

In this particular case, the insurance company hired an Engineer to support their position that the damage was not covered. The engineer stated in his report: “In our opinion, all but one of the observed damages within the structure, including the attached garage and observatory, are attributable to wear and tear and/or historical moisture infiltration through the structure’s exterior, either above grade or below it.” “Therefore, it is our conclusion that the damage occurring to the home, as per the areas outlined in the report, is due to long term exposure due to the lack of maintenance, as well as water seepage into the home due to surface or ground water.”

Sadly, the insurance company and their hired engineer failed to review all the evidence which caught the attention of Public Adjuster, Rick Tutwiler.  According to Mr. Tutwiler, this particular insurance company recently prepared and provided its insured with a Home Appraisal Report on December 6, 2011.  In that report, none of the issues raised in any of the letters or engineering reports were raised during that inspection of the risk prior to the insurance company collecting a large premium for insuring a huge property. 

Specifically, the appraisal report and the photographs submitted by insurance company appraiser clearly show the property to be in pristine condition with no issues at all.  The appraiser even goes on to outline her recommendations for Safety and Loss Prevention measures to help reduce the chance of loss or damage.  Nowhere does the insurance company appraiser record any pre-existing damage issues, lack of maintenance, or seepage that the insurance company alleged.   

In addition, the owner recently remodeled the home, which he had professional photographs taken in August of 2013.  As depicted in the photographs, the property appeared to be immaculate and well cared for.  Nowhere in the photographs was there evidence of any pre-existing damage.    

After pointing out all the discrepancies noted above, the insurance company came to the table in an attempt to resolve the claim.  Soon after, the claim settled in the high six figures allowing proper repair of this special property. 

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  • Public Adjuster Helps Hampton, New York Homeowner Win Battle On Ice Dam & Winter Storm Damage Insurance Claim Dispute