Dealing with insurance adjusters

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I did exactly that with the adjuster. She claims sheetrock repair, stain sealing, painting can be done for $1100. I have quotes from 4 painters from $2800 to $4000. The $1100 is just so totally out of whack for the NJ/NYC area in particular, that it's a joke. So, I said to her, fine, give me the names of a couple painters who will do it for $1100 and I'll call them. She says Allstate doesn't do that, but they know that it can be done for the $1100..... After insisting for two days that they will only pay for one coat, I now have her conceeding to do two coats and the amount is up to ~$1800. Still low, but better.
How about this. They had $74 for replacement of a powered roof fan. Upon looking closer, I see it actually says it's for the "cover only". So, I'm like, they don't sell just the replacement top part for a roof fan. Especially not for a 25 year old one. She insists that yes they do.... Just ask your roofer. Fortunately the roofer was just getting in his truck. So I yell, down to him... Answer: They don't exist. She did then go redo it and I think there is like $250 in there for it now. But it justs makes you wonder what experience they really have.....
Also, the most extensive water damage was to a section of cathedral ceiling. The worst shingle damage was also to the very peak of that ceiling. The cathedral ceiling has not been opened to verify that it's dried out. For all I know, it could still be soaked. So, I proposed that they pay for pulling a couple sheets of plywood as part of the re-roof to verify that it's dry and OK. She says it's pefectly fine for plywood to get wet, they even do it in new construction. I tell here, yes, but that's without insulation underneath and drywall ceiling the cavity. It could be full of water and could mold. She says that just doesn't happen......
In retrospect, the right thing to do would have been to open the drywall from the inside across at least one section so that it could dry out quickly, etc. Then they would be paying for that.....
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Jimmy Volleyball wrote:

Interesting information, especially about asking for the name or names of skilled technicians that the adjuster believes will honor the adjuster's estimate.
Could you say a little more about the "public adjuster" idea? That's different than hiring an attorney. Do you think that public adjusters who represent the policyholder are a good idea? -- sometimes, always, never?
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wrote:

Yeah. They are a kind of "traitor" to the typical company adjuster but they really do a good job for their clients. Many plaintiff attorneys try to run them out of business because they keep the attorneys from earning a big fee. The trick here is to tell the adjuster exactly what you expect and know what he/she is going to charge you to do the job EXACTLY as you want it done. They will usually be very honest about what you will be able to collect for and what you won't. Also, be that adjuster's note taker. Follow them every step and take notes and argue you case when you think they might have missed something. That way YOUR adjuster knows all of your concerns and they know the language and how to get you the best deal. But, just like everything else there are the good ones and the not so good ones so stay on their heels and express your concerns no matter how trivial. They work for you!
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Jimmy Volleyball wrote:

Thanks. That's excellent information.
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I had three experiences where insurance claims were involved. All three were fire damage, on residential, two industrial.
Case #1 Public adjuster got much more done than the insurance adjuster got. Homeowner also paid for some extra work and upgrades at the time.
Case #2. The insurance company paid the maximum of the policy so an adjuster would get no more. Why pay an adjuster for that?
Case #3 Adjuster was able to collect on damages that we would not even think about. This was a payout of over a million dollars. Well worth the 10% fee.
Oh, fees are negotiable.
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People should ALWAYS BUY REPLACEMENT INSURANCE!
Not the depreciated value where the homowner ONLY gets paid for the cost of stuff from goodwill........
This 5 year old sofa was 700 bucks new now valued at 100 bucks
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wrote:

If you are REALLY lucky.
Replacement cost is only a few bucks more - raise your deductible by $50 or $100 and you come out ahead.
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I have replacement coverage. But they still screw you. Here's another trick. On the roof sections that they will pay to replace, they won't pay for ice daming material along the lower sections. Why? Well, the house does not have it now, so they say it's an "upgrade". But both I and the roofer stand there and tell the adjuster it's mandated by code. Her response, you're policy doesn't have a "to code" provision. That's an increased premium over replacement coverage. WTF? You can't replace the roof and not do it to code, so why shouldn't they pay?
Ultimately that's one thing I'm going to fight them on more, but waiting until I figure out how to proceed.
As for the sofa, I had an older sofa that was in the loft that got some water damage on it. It's not totally wrecked, but it has spots that won't come out. She gave me $200 for it.
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On Sat, 23 Mar 2013 04:42:42 -0700 (PDT), " snipped-for-privacy@optonline.net"

Sounds like they are paying for replacement, just as your policy states. Doubt you'll get any more than that as you are getting what you paid for.
Step back for a minute. What if you were insuring your next door neighbor's house. He has roof damage and you agreed when he took out the policy to provide replacement. Meantime, codes changed. What would you pay? Would you have upped the premium he paid you?
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That's all I want. Replacement of the roof section. You can't replace it without doing ice dam, it's not allowed by code. It's would be like saying we pay for replacement of an AC unit, but won't pay the extra $200 because today they are more expensive, use R410A, etc.

If I'm insuring it, then I'd pay what it takes to replace the roof to existing code. You cannot replace it otherwise. I didn't set the $1800 premiums, Allstate did. They should know that in almost all cold areas of the country ice daming is required on the lower sections. It's part of the national/international building codes.
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On 3/23/2013 7:42 AM, snipped-for-privacy@optonline.net wrote:

Insurance is a contract. If the terms state replacement then as an example you get the value of a 10 year old paint job not the money to do a brand new paint job.
Why would they pay for ice dam material or anything else that you didn't have if the terms do not provide for it?

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No, you have that wrong. There are two types of policies. Cash value and replacement cost. With replacement cost, you get the full cost to replace it, regardless of the age. With cash value, you get the depreciated value of the item. I have RCV and have been paying the higher premiums.

The terms provide for replacement of the roof. That should include what it actually takes to replace it. You can't choose not to use ice dam material, its required by code. The roof cannot be replaced without it. If I was asking for something that is optional, eg upgraded shingles, that would be a different story.
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On 3/23/2013 9:15 AM, snipped-for-privacy@optonline.net wrote: ...

But, if it wasn't included originally, it isn't replacement. The policy almost certainly doesn't say "rebuild to current code" but "replace existing".
Don't think you're likely to get anywhere on the change in code provisions part unless you can find something in the language of the actual policy that implies such. Otherwise, they're correct in the interpretation of "replace".
Again, as others have noted, you should be able to get in touch w/ your State Insurance Commisioner's office (or whatever it's called there) and find out what actual regulation from the State is -- or may even be on a web site FAQ sufficient info to tell whether you've got a beef that might have even a proverbial snowball's chance or not. (My guess is not, but won't tell you not to push as much as can...)
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Explain how you replace a roof without doing it to code. I had a roof. It's gone, it has to be replaced.
How about this. Let's say I have an old 50" rear projection TV and it gets damaged. I have a replacement cost policy. It's just as impossible to replace that TV with an exact new one as it is to replace the roof without ice dam material. Let's say I find someone who has a brand new 50" rear projection TV still sitting in the box. It's $5000. Is the insurance company going to pay to replace it with that, because it's the exact replacement? Or are they going to buy a new 50" TV for $700 and give me that because it's the functional equivalent and what is available today?
Or how about if you had a car accident and the OEM original part cost $100, but it's no longer available. All that is available is a similar part, but it's better quality and cost $300. Can the insurance company say, we're not paying $300 for it, because it's a better part? Or do they have to fix the car, so it's functional again?

I disagree.

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On 3/23/2013 10:47 AM, snipped-for-privacy@optonline.net wrote:

But the insurance doesn't have to pay the difference between what was and what you want is the point unless the insurance contract actually says so--and I doubt it actually does.
...[immaterial strawman arguments elided for brevity]...

...
Well, let us know if you prevail, but I'm not betting on anything beyond the strict interpretation of "replace"...
Again, read the fine print of the actual contract (not just the summary pages but the actual full text) and check w/ the State but I think replace will be replace as original not replace w/ additional.
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Had a friend who had a home fire in a 200 year old poor condition home that still had some knob and tube wiring.
The insurance company paid for a complete rewire, including GFCIs, arc fault breakers everything including insulation, when most of the home wasnt insulated at all:(
INSURANCE IS REQUIRED BY LAW TO BRING EVERYTHING ITS PAYING TO REBUILD UP TO CURRENT CODE!
Whoever has the problem with them refusing should call their states insurance commisioner! One letter from them should get the company to cooperate:)
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On 3/23/2013 11:39 AM, bob haller wrote: ...

...
Nonsense.
The building code may require a given level of reconstruction to obtain occupancy permit, etc., but that a given policy will cover the cost above that of original replacement is dependent on the terms of the policy.
There are policies to cover such known as "law and ordinance" policies but even they have limitations.
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On 3/23/2013 12:13 PM, dpb wrote: ...

BTW, afaik, FL is the only state mandating insurors provide such policies. Homeowners there can opt out to avoid the higher premiums but must sign an explicit waiver to do so. Elsewhere, it's up to the insured to purchase such riders if desired.
--


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Thank you. That's a mighty fine example. What I'm asking for, is just a little bit more for ice dam material.

We aren't at that point.....yet
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On 3/23/2013 12:39 PM, snipped-for-privacy@optonline.net wrote:

...
Example of what? Totally different case and I seriously doubt the insurance company actually did much (if anything) that wasn't in the terms of the particular policy. For fire protection they may have a policy of improving simply as a a future cost-avoidance measure.
My observation has also been that in cases of "one of" claims they'll likely be somewhat more flexible in adjudicating claims than are in such widespread disaster claims simply owing to the large exposure overall. I don't have access to the actuarial data internally to be able to tell but I have long suspected the insurance companies don't adequately address common-cause large-scale events in their rate-making computations so that hurricanes in particular do them serious financial damage (in their terms, anyway :) ) and they are therefore pretty aggressive in trying to limit the exposure after such events.
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