Dealing with insurance adjusters

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Well it would seem to be a case where a house had old wire, a fire and the insurance company paid to bring it up to code. He did say they paid for GFCI's and insulation when the house was not insulated at all. It's not 100% clear what he meant about the GFCI's, but I think his meaning was that it had knob and tube and no GFCIs, yet they paid for a complete rewire.
Totally different case and I seriously doubt the

Oh, I see. It makes sense to spend to put in a new electrical system that is up to code, because it may avoid future costs for the insurance company. But not ice dam material? What's up with that? Ice damming costs little and could avoid BIG claims for water damage.

Which doesn't have anything to do with what's right or the premiums I've been paying.

Yeah, I know they are trying to screw me. That doesn't make it right.
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On Sat, 23 Mar 2013 10:39:15 -0700 (PDT), " snipped-for-privacy@optonline.net"

How much is the material? The stuff I saw was $150 to do a typical house.
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On 3/23/2013 11:18 PM, Ed Pawlowski wrote:

Current price is ~ $150 for a 75' roll
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wrote:

In that case, it comes down to how much time are you willing to invest for $150. That applies to both sides. Allstate will have to spend a fair amount of money to keep denying the claim
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On 3/23/2013 1:39 PM, snipped-for-privacy@optonline.net wrote:

The irony of all of this is that you are such a staunch defender of big soulless organizations (including things like the bank bailouts etc). So maybe this is your thanks?
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On 3/23/2013 12:39 PM, bob haller wrote:

They are only required to do what is in the contract. Many policies are written such that they pay only for the current value. If the paint job is ten years old you get that value and not a new paint job. If the building has say 40 year old wiring with a knob and tube wired outlet in each room you get that value not the cost to wire the building to current code.

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licy

Again, it's *not* what I want. It's what code requires. How about this. I'm paying replacement cost coverage for the whole house, $400K limit. If the house burns down, I'm entitled to a new house that has the same square footage, same style, same number of floors, etc. So, 25 years ago:
GFI was not required in a kitchen, outside, in a garage, basement, etc Insulation was typically say R-12, today min by code is R-18 Arc fault was not required in bedrooms, living area, etc, today it is
So, while Allstate is saying the house is covered for $400K replacement cost, you think they can say we're deducting X, from the electrical work, Y, from the insulation, etc? Even though that is the min that is required today? Then why am I paying for $400K in coverage, which is what it takes to actually replace the house, which both I and Allstate agreed to, if they are going to subtract out stuff and then say it cost $375K to replace? The simple fact is you can't replace it without complying with code, that's an implicit part of the whole thing. Now if it costs so much to comply with code that it exceeds the agrees insured value, then that's another thing.
IMO, they are trying to have it both ways. I'm paying for replacement cost capped at $400k and then they are trying to be cheap and not build to min codes. Is expecting it to be built to min codes so unreasonble? WTF am I paying for?
unless the insurance contract actually

They aren't strawman arguments, they go precisely to the point.

That is the strict interpretation of replace. I paid for replacement coverage of the roof. I'm entitled to it being replaced. The fact that code today requires that it cost a little more money isn't my problem. And Allstate knows damn well what the code requires when they agreed to replacement coverage.

One more time, IT CANNOT BE REPLACED WITH ORIGINAL because min code does not allow it.
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On 3/23/2013 12:37 PM, snipped-for-privacy@optonline.net wrote: ...

One more time, that doesn't mean the replacement policy covers the differential cost; only the cost to the _original_ condition.
They're not telling you that the repairs won't be to Code; only that their liability is limited to the state of the existing building prior to the damage.
Look up "law and ordinance" riders/policies. As noted above, AFAIK, only FL mandates them (and that only after the big hurricane season when it became such an issue).
And, again, check w/ the State--if there is any such requirement in your locale they'll know it and be able to tell you your recourse under the law. W/o that knowledge you're just blowin' hot air into the teeth of the gale.
I commiserate w/ the problem but w/o some ammo in your gun I think you'll continue to shoot blanks at the target, unfortunately. What you think should be isn't necessarily so.
Oh, do you have a local agent you know well? If the national folks are sending in contract employees and aren't living up to the terms this dude should be able/willing to help. At least he can explain the limitations of the policy coverage. He certainly ought to be able to explain the question of what "replacement" means and whether the newer Code requirements are covered or not. Ask him if they sell the above riders--to late for this claim, of course, but will show the difference in coverages if not included in yours as I suspect is (unfortunately) so.
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I think the fundamental disconnect here is that you are looking at the insurance company's obligation as replacing a bunch of pieces, individual components. Shingles, nails, wiring, plumbing, etc. It doesn't work that way. If for example I had a house that burned up, with replacement cost coverage I'm entitled to a new house that has the same functionality as the old one. That is a house with the same square footage, same number of rooms, that has a kitchen bedroom, etc. The fact that today more insulation is the min to code, and that gfci, afci are required, ice daming for the roof, etc and that you can't replace it without it isn't my problem. Without doing that I have no replacement house period.
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On 3/23/2013 12:54 PM, snipped-for-privacy@optonline.net wrote:

_I_ think the disconnect here is that you're looking at the insurance company's obligation to have provide a level of replacement beyond that of the original building condition. It doesn't work that way.
See previous comments explaining more about why and how to deal with it going forward...
There's a (I think very slim) chance an adjuster is being overly zealous here, but I really do think the actual legal financial obligation will be determined to be only to the existing condition prior to the damage (unfortunately, and I'm sorry, but that's what I think will be the end result).
The cost of then meeting the additional code reqm'ts, while real, are almost certainly not going to be covered in a policy that doesn't have the explicit rider.
Again I have no way to get to the internal information to determine it is so, but I suspect another thing that has happened goes along w/ my previous supposition re: large-scale disaster coverage--that the insurance companies became much more restrictive in the interpretation after the Gulf debacle when it became clear their rate structure just wasn't computed on the basis of such widespread simultaneous claims but rather treated each individual policy holder as an independent risk. That works pretty well for the random fire or even for (relatively) small disasters like tornadoes but when entire states/regions are impacted at the same time it breaks down entirely.
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When I got HO insurance State Farm explained to me some options:
Replacement Cost on Contents (I think that's standard with them, at least i n NY, and it's a darn fine thing to have) also Build to Current Code on the house itself- exactly the issue here- that if my house wasn't up to current code and there was damage to be repaired, the extra cost of bringing it up to current code would be or wouldn't be inclu ded, depending upon whether I chose that (more expensive) option.
If that was an option when you bought insurance and you didn't choose it, t hat was your choice.
When I got insurance I asked what I thought was a reasonable question- what options am I paying for that I might not want, and what additional options are available (such as jewelry, furs, etc. that have sublimits, plus home business equipment coverage, higher liability limits...).
In your case it sounds like you didn't pay for something so you didn't get it. You will have an improved roof vs. what you had before the disaster, bu t you'll have to pay the additional cost for the improvement.
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On 3/23/2013 2:16 PM, snipped-for-privacy@brainchampagne.com wrote:

...

Ayup, what he doesn't want to hear is likely the case.
I still think it would be interesting to be able to see into the rate-setting/coverage boundary processes internal to the underwriters to see how the coverages have been squeezed over the years ('cuz I've no doubt they have been for various reasons most notably the aforementioned obvious one of the heavy losses sustained after the successive Gulf coast years).
--




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Just a slim chance? The same adjuster that looks at a wall with 7 windows and two doors and takes out the area for them because they don't have to be painted, then applies a cheap per sq ft painting cost? Any painter knows that cutting in around all those windows, doors ADDS to the cost instead of decreasing it. The same adjuster that says it only takes one coat to paint water damaged walls and ceilings? The same adjuster that says that a power attic roof fan with ripped up top can be fixed by buying a new top for it? You ever see those sold? For a 25 year old fan? That adjuster and insurance company?
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On 3/24/2013 7:07 AM, snipped-for-privacy@optonline.net wrote:

Yeah, that one... :)
What you've not provided is any specific details on the policy, your relationship w/ and support (or lack thereof) of the agent, etc., etc., only your (understandable) frustration based on what you believe should be.
There's been much good advice given but little sign of follow-up (or at least relating the results of any).
I'd reiterate what I've said earlier and then look into the independent adjustor as others have suggested. Do you know how this adjustor got assigned? Is he/she as I suspected an out-of-area itinerant specializing in disaster-area adjusting? They show up here in hordes like locusts after large hails and are, indeed, a plague I will agree.
The thing is that you need to get factual first on what your policy does indeed say rather than just repeating that what it is that you think it _should_ say. I know I'm repeating myself but it doesn't seem to be getting through...
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OP should call his states insurance commisioners office with a simple question, do insurance paid for repairs need to meet current building code?
My experience says it does.....
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On 3/25/2013 9:41 AM, bob haller wrote:

He's been told that innumerable times to check and see what is in place in his jurisdiction, yes. So far, no indication he's done so.
But, in the end, it will be what his specific policy terms are that will have final say-so, I expect.

Your experience is dated. See earlier posted links and DAGS on 'law and ordinance' rider/policies.
As pointed out there and AFAIK at this time in the US only FL has state law that mandates that new policies contain the clause/coverage by default. If it's been incorporated into statute/regulation elsewhere, it's recently.
And, as noted, it seems it started being a tactic after the spate of gulf coast disasters and it's only after that that FL instituted their reg's/laws. I'm pretty sure one eventual side-effect of Sandy will be to cause such to happen in the NE as well.
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wrote:

Of course they have to meet code. But that does not mean they have to pay for all of it. They only pay what is covered. Did you read the policy? No one here has so anything we say is speculation.
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Ultimately the adjusters job is to settle claims as cheaply and quickly as possible for the company...
I have delt with some, they like fast and cheap/
I still believe they MUST meet and pay for code requirement upgrdes,,
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Bob, I agree with you in concept. The way you and I see it, if you're paying for replacement cost coverage and your bedroom burns down, the insurance company should be responsible for paying for a new bedroom that is the same size, same functionality as the old one. That code now requires arc fault, more insulation, ice damming on the lower roof, etc, is their problem. You paid for replacement of a bedroom, they have to replace it.
But DPB is right that the clever insurance companies have exclusions in most policies that say they don't have to pay for it. Or at least they think it means they don't have to pay for it. Did you see that Colorado case I posted the link to? The policy in that case had exactly that, an exclusion. The house burned down and Allstate said they were not required to pay for things now required by code. The lower court agreed with the insurance company. On appeal, it was reversed, because the appellate court cited case law where if the overwhelming verbage of the policy would lead a reasonable person to believe that it was covered, tricky exclusions can be ignored. They said the overall policy was clearly to put the homeowner back in the position they were in pre-fire. That means they had a bedroom then, they are entitled to a bedroom now. The fact that some code changes mean it costs more does not mean the homeowner winds up in any better position than they were pre-fire. They still only have a min code bedroom. That was the essence of the finding.
And following that, they probably crafted the policies better so as to still be able to deny it. In short, at best it's a grey area and could vary from state to state depending on the laws there, the court rulings, etc. And in my case it's a couple hundred buck, if the insurance company won't cover it, it's not worth a big fight. BUT, I think it is worthy of discussion for two reasons:
1 - I don't think it's right
2 - Anyone that has replacement cost coverage should be aware of this. Worst case, let's say you have a house that you've been paying for replacement cost on for 25 years. It covers the house to $300K. The house burns down. The insurance company could total up what they say it takes to build a new one, that isn't up to code. Suppose that can be done for $250K. So, even though the policy says they will pay to replace the house, they give you a check for $250K and refuse to pay the other $50k, because that is for code required items that were not required when the original house was built.
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On 3/26/2013 8:26 AM, snipped-for-privacy@optonline.net wrote:
...

I had missed the end result in the CO case before indeed...that's interesting that the court did strike the exclusion down owing to the preponderance of implied coverage to make whole. If undoubtedly help the insured in that case to have been in what is now a very liberal-leaning State in making the appeal.
As noted, I'm sure the underwriters' lawyers have studied that (and any similar) decisions _very_ carefully and have wordsmithed the language to try to ensure it will be enforceable in the future.
As you, I think it's a despicable ploy; nothing I've written previously should be interpreted as being supportive of the idea; only that it's definitely not a given that coverage will be automatically given to cover additional Code or other occupancy reg's in place since the time the original structure was built.
As noted earlier, I think there was a big problem in the casualty models used in setting rates for catastrophic losses in that they forgot about/essentially ignored common-cause and the magnitude of the possible damage area affected by these events as the population and particularly evaluations in these coastal areas grew exponentially over the years w/o any major events. After that, they were left with such massive losses they've resorted to whatever could to try to limit liability.
Also as I noted before, I believe one upshot of Sandy will be that FL-like legislation will follow in the NE and along all the Atlantic coastal areas w/ time that will mandate that policies include the rider by default and homeowners will have to explicitly decline it if choose to not pay the additional premiums that it will entail. And, of course, while it will provide coverage, "there is no free lunch" and rates will rise to cover it. Of course, they're rising anyway to cover the problems the last few years have uncovered in the actuarial rates were using, anyway...
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