Policyholder Question: Buying Flood Insurance and What You Need to Know

Here is an insurance claim question that we recently answered as a contributing member of insurance claim experts for United Policyholders who advocates for property owners. 

Q. I have been offered a job in Wilmington, NC and would like to live in a nearby beach community such as Surf City, NC.  Other than USAA, What is the best insurance carrier for flood insurance? 

A. Before I answer your question, please allow me to give you some background on flood insurance as our public adjusting firm has seen significant changes over the years. Because of the high risk of flooding and the widespread damages that often result, the insurance actuarial folks could not manage or price this peril so as to set an affordable premium. Thus the private insurance industry was simply not agreeable to assuming the flood risk. Thus, flood losses were excluded in most all standard property insurance policies. In 1968, the National Flood Insurance Program (NFIP) was created by an act of Congress as the lack of this coverage was affecting the economy and commerce. In the beginning years, this program while providing flood coverage, was very poorly run and claim service was terrible. Probably not surprising given that the NFIP was headquartered in Washington, D. C. as it quickly became a typical Washington bureaucracy, unresponsive and extremely difficult to work with.


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Policyholder Question: Insurance Claim Repair Delays

Policyholder Question: Insurance Claim Repair Delays

Q. How can we make sure our insurance company is moving ahead with our repairs, etc?  Right now, everything seems to be on hold until they can get a joint inspection with our contractor's insurance company. Our house has been sitting for over a week with no heat, no electricity, etc., while we wait for this joint subrogation inspection.


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Policyholder Question: Can I Refuse Cleaning and Inventory Services from my Insurer?

Here is an insurance claim question that we answered as a contributing member of insurance claim experts for United Policyholders who advocates for property owners. 

Q. Can the insurance company force you to use an outside vendor to inventory your personal contents rather than allow you to do it yourself?  Can you refuse cleaning and inventory services that an adjuster is trying to make you use?


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What do you do when an insurance company exercises their right to repair?

This question was asked of us the other day and since it is rarely encountered in the everyday world of property insurance adjusting, I wanted to share it given our experience with “the option to repair tactic” that we’ve seen used by the insurance carriers. First, a little background on this controversial clause found in most property insurance policies.
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Policyholder Question: How Much Depreciation Should be Taken for a Driveway?

Here is an insurance claim question that we answered as a contributing member of experts for United Policyholders who advocates for property owners. 

Q. What, if any, should be acceptable ACV on a driveway and walkway on a personal residence?  House was demolished by fire and working with adjuster on fair settlement value of these surfaces.  Policy provides ACV.


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Policyholder Question: Frozen Pipe Burst Claim Dispute - Is it Time to Hire a Public Adjuster?

Policyholder Question: Frozen Pipe Burst Claim Dispute -  Is it Time to Hire a Public Adjuster?

Here is an insurance claim question that we answered as a contributing member of experts for United Policyholders who advocates for property owners.

Q. I had an upstairs pipe burst 1 month ago that caused damage to the upstairs bathroom (tile & drywall), carpet in upstairs (hallway & one bedroom), all of downstairs kitchen (walls, cabinets, ceiling, under-house insulation, HVAC ductwork). After quickly stopping the leak and vacuuming out the water, I set up my claim and started calling water damage restoration companies.  Of the dozen I called, only one could come out sooner than 5 days.  They began drying and demolishing within 2 days.  After my persistent calling, an adjuster finally got in touch with me 8 days later to setup an appointment.  This appointment was 24 days after initial damage!  Now I will talk about my dispute.  Two adjusters showed up.  The upstairs tile had expanded and contracted enough to bust loose.  The tile creaks badly and the adjusters bent down with me and clearly observed it moving.  However, they still were insistent on not replacing it.  I have continuous carpet (mended seamlessly at the thresholds) all over the upstairs including stairs.  They wanted to cut above the stairs and at thresholds, citing they only had to replace what was damaged.  Downstairs, they wouldn't even consider the tile, although I know that it was wet under those tiles for at least a week with plenty of time for mold spores to form.  Every piece of plywood under those tiles was wet and didn't get insulation removed for 4 days and never had a fan or dehumidifier put in the crawl space.

Where do I go from here? I thought I should first write the adjusters a letter in my defense.  I was an engineer for The Tile Council of North America which publishes industry-consensus guidelines for ceramic tile installation. I have plenty of expertise and sources to back my concerns. Or should I just get a public adjuster? Thank you!


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Policyholder Question: What’s Covered in a Pipe Leak Water Damage Claim?

Q. I have filed a claim for water damage to my living room. The adjuster provided details of coverage prior to mitigation, for $1, 762.68 including my $1,000 deductible; for which I paid. The mitigation folks provided another estimate of an additional $6,000 to my insurance adjuster. This was their estimate once they opened up the wall where the water was causing damage. Two major findings, once they opened up the wall: 1) they discovered a pipe leak 2) two beams are termite infested! Neither are covered under my insurance (Nationwide)! The company that came in to do the recovery completed the cleaning, disinfecting, and drying out process. However, they informed me that they would not replace the wood beams that are damaged by termites. I paid for the restoration of the pipe out-of-pocket but cannot afford to pay anymore additional repairs. I explained this to them; to which they replied, "you can cash out and get another estimate." I told them that I needed to get further guidance. They said they would get back to me and left. I have not heard from them, and now I have one wall and part of the floor in my living room exposed. What are my options?
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Policyholder Question: How long does an umpire have to make a decision?

First a little background, an umpire in the insurance property world has nothing to do with baseball except that a baseball umpire and an umpire in a property insurance dispute have one thing in common--both have to make a decision. The baseball umpire will have to make a decision quickly, where as an umpire in the appraisal dispute resolution forum should take as much time as needed to make a decision based on all the facts. A good umpire will thoroughly review of all the materials provided to him or her by the two appraisers (representing each side of the dispute) who agreed to his or her appointment. This can and often should include a visit to the loss site (if the property in question is still standing) along with the two appraisers and the policyholder if they want to understand the opinions as to why the initial adjustment was wrong.


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Policyholder Question about Mold in Apartment due to Air Conditioning

Q. My tenant reported mold in a house that is 6 years old. We had a company test and they said the mold was caused by the a/c, due to a low refrigerant level, which caused high humidity levels in the house. At first, the insurance company said we were covered. But when the tenants request reimbursement for a medical x-ray, which showed a spot on the lung, the insurance said we were not covered. They said it was not a covered peril. They said that the a/c caused the 70% humidity which caused the mold. The remediation estimates are in excess of $30k and it appears there will be a medical claim. There were 69 days involved from the time the tenants first noticed the mold until they vacated the house. Also, the tenants’ personal items are supposed to be discarded. Am I responsible for that? The lease required them to have renters insurance but this is the second year of the lease and they did not renew it after the first year. Also, I have seen web ads for a mold bomb fogger that is supposed to be approved by the EPA. It is from Biocide Labs. Has anyone ever used it?


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Policyholder Question: Water Damage Claim and the Restoration Company’s Cleanup Bill, Who Pays & How Do You Get It Paid?

Q. I had water damage in my house due to an over flowing toilet. My insurance company said it would pay $8,000 to the restoration company that did the clean-up. The problem is that the restoration company who did the water extraction sent me a bill for $36,000. The insurance company sent me a check for $8,050.  Should I mediate or go the appraisal route?
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"On Property" Insurance Claim Tips Blog

Tips and advice about how to properly file and protect your property damage insurance claim and get a fair settlement. We invite all readers to ask questions about their claim so our public adjusters can post answers for others to benefit. Insurance claim expert guest bloggers welcome to submit posts via our contact form.

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Local Office

Tutwiler & Associates Public Adjusters, Inc.
Licensed Public Insurance Adjusters & Loss Consultants
Offices: Tampa, Orlando, Palm City, Ft. Myers, Florida; Dallas, TX; Pittsburgh, PA

Executive Office
4300 W. Cypress St.
Suite 780
Tampa, FL 33607
Phone: 813.287.8090
Toll Free: 800.321.4488

Licensed in Florida # W840088 &
Texas #1399706 plus 16 other states
and the Virgin Islands