On Property Insurance Claim Tips Blog

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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Flood Insurance: The Other Part of the Story Not Being Covered by the Media and Others

An editorial written in the Washington Post titled “Reforms should tackle flood and moral hazard” and reprinted in the St. Petersburg Times (2/4/2014) attempts to make a case that the U.S. House of Representatives should not follow their colleagues in the U.S. Senate and repeal the dastardly Biggert-Waters 2012 “Flood Reform” act. No need to go into a lengthy accounting on what’s in this piece of legislation and what it’s doing to still recovering homeowners. Examples of their pending financial ruin are constantly in the press and ubiquitous across the Internet.

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Flood Insurance Issues Persist for Sandy Victims

This article from the NY Times, Sandy Victims Insurance Headaches Persist points out the rules and regulations are stacked against the policyholder. The National Flood Insurance Program is a terrible and troubled insurance scheme. With 41 years on the clock dealing with the misery of others at their time of loss, I think it’s time to reform or eliminate this program with its draconian adjusting rules. Read More

The Big Freeze Broken Pipes and Snow… the Way It Was

While looking for some information in my office library yesterday, I pulled a book from a shelf titled The Policyholder Advisor authored by Eugene R. Anderson, William G. Passannante, and Robert M. Horkovich. These three gentlemen, all attorneys, and at the time of publishing in 2002, shareholders at Anderson Kill & Olick P.C. now Anderson Kill P.C. one of the nation’s leading law firms for policyholders. The book jacket noted that the book is a collection of articles published in the firm’s newsletter, “The Policyholder Advisor.”

It was a little uncanny when I opened the book, and it opened to page 181 and the chapter title was “Insurance Coverage Available for Property Losses from The Blizzard of 96.” While no two storms are ever the same, there sure are a lot of similarities between the 1996 blizzard and the current polar vortex malaise of 2014; especially when it comes to insurance coverage issues and disputes with insurance carriers.

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Frozen Pipes, the Resulting Water Damage, and Now Snow--Is It Time to Call in the Cavalry?

Frozen Pipes, the Resulting Water Damage, and Now Snow--Is It Time to Call in the Cavalry?
With another polar blast and big snowstorm adding to the misery in the already frozen Northeastern U.S., I was wondering how the property insurance industry is holding up given the onslaught of property claims being filed. Well, that question was answered when we received an auto-reply from an adjuster in New York who works for one of the big insurance companies who we are working with on a claim following Super Storm Sandy. His reply, “please be advised that we are currently experiencing higher than normal volume due to recent weather related events and there may be a delay in returning your email.” Returning timely emails is one thing, but adjusting a loss is a whole other animal given the working conditions in the frozen north; especially when it comes to frozen pipes.Read More

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?Read More

Broken Water Pipes from the Big Freeze “Polar Vortex” What a National Mess!

Broken Water Pipes from the Big Freeze “Polar Vortex” What a National Mess!

Yesterday, I was on a flight to sunny South Florida to meet with a client, and ran into a large loss adjuster who works for one of the major insurance carriers heading the same way. When you meet a fellow adjuster or colleagues who are in the business, usually the first question is to ask if you are busy. This seasoned adjuster side tells me the claims are rolling in from the areas that were affected in the big freeze caused by the “polar vortex” last week. It seems his company is so overwhelmed, that they have staffed call centers with independent adjusters just to handle the call volume.


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Where’s the due diligence from financial institutions when it comes to property losses on residential and rental investments?

Throughout my career, I have always been amazed about the fact that financial institutions like mortgage companies, banks and credit unions, all who have a stakeholder’s interest in a property, (either through a mortgage or some type of financial interest or obligation) never seem to question a claim payment made by an insurance company following a loss. I realize they are in a unique position, either as an additional insured, lien holder, mortgage holder, bankruptcy receiver, etc., and their client, the insured, is supposed to be on the frontline looking out for their own financial wellbeing.  But it’s their security interest or in some cases a fiduciary responsibility that is at stake. So you would think they would have more than just a passive interest to confirm that a settlement on a property loss is correct and payment is in accordance with the policy and the facts of the loss. Read More

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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Our 2014 Public Adjuster Wish List for the Property Insurance Market

It’s been an eventful year for public adjusters and the insurance claims industry. So I want to share my 2014 News Year’s Wish List for the property insurance industry.

  1. I wish Congress would fix the Biggert-Waters 2012 National Flood Insurance Reform Act. This extremely ill-conceived act of Congress is causing great harm to homeowners all across this country. Remember, an affordability study was supposed to have been commissioned with this legislation but is now two years away according to some accounts in the media. Meanwhile, policyholders who have been in their homes for years (and I am not just talking about high priced homeowners) are hurting because of premium increases and no buyers for their property. Shame on Congress for this!
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