I was referred to a repair by a dry out
company from Mesa, Arizona. When I arrived it was explained to me that a
loss had occurred under the kitchen sink. One of the angle stops had
begun to leak and had soaked the sink cabinet and the cabinet next to is.
No great shakes, it happens. The homeowner told me that she had already
had the insurance company out and that they had forwarded a repair scope of
work that included a replacement of the sink cabinet. Conveniently, they
had included a quote from a local cabinet shop (this shop does pretty good work
and I had even used them before based on one of these quotes provided by the
insurance company). They seemed to have given a fair quote for the
replacement of the sink cabinet and according to the insurance company scope of
$1,340.00 the face of the old cabinet would be reused. I struggled with
that for a couple of reasons. First, the face of the existing cabinet had
been stained by the water that had run out of this cabinet onto the floor during
the leak. Second, there had been no thought to address any damage done
behind the cabinet during the leak. It was now dry and I guess since it
was “out of sight” it could be “out of mind”. Third, there was no thought
given to the damage showing inside of the cabinet adjacent to the sink
cabinet. Given there was minimal visual damage and only on the inside at
the bottom but it was obvious that it had been wetted most likely during the
leak and was not the same as it was. I spoke with the home owner and told
her that I felt that she should be getting more out of her claim. I told
her that the insurance company wanted to replace the cabinet box and reuse the
damaged face in order to avoid replacing all of her kitchen cabinets. You
see when cabinets are in a house for a long time (a few months to years) they
change color for many reasons (light, chemicals, maintenance etc.) they are
altered and even if they are replaced in part by cabinets from the same company
they most likely will not match the cabinets that have been left in
place. I wrote a repair scope that accomplished this repair and submitted
it to the insurance company. After the insurance company received my
quote the desk adjuster who had been assigned to the claim called me asked why
my scope of work was $12,000 and the adjuster who had visited the site was at
just over $1,300. I explained that I did not feel the cabinets would be
properly repaired the way they had proposed and why I felt that way. He
was understanding and offered to send the cabinet shop out to review the things
that I had explained. I met with the cabinet shop and the home owner a
few days later and explained the issues. In addition, I asked the cabinet
shop to include an explanation of the trims and panels that they would be using
to make the repairs. It turns out that the trims that would match were
not even available and that many of the other materials that they wanted to use
to make the boxes were very similar (likely the same materials used in the
original manufacture of the cabinets) without the custom exposure that the
existing cabinets had received. With the revelation of that information
the insurance company saw that it would not be able to bring the policy holder
back to “pre-loss condition” or to be like the loss never happened without a
full cabinet replacement. This work is now completed and the client is
very happy.
Tuesday, October 30, 2012
Friday, October 12, 2012
I am a convert to using public adjusters!!! Observations of a Restoration Contractor.
When the construction industry in Arizona
turned in 2008, I found myself changing from commercial ground up construction
of retail buildings to mostly residential insurance repairs. This field
would not have been my first choice at the time, but since flood and
fire do not really care if there is a recession, it seemed like a great place
to be until things got better. One of my first assignments was to make an
estimate for a family who had suffered a fire. The quick details of their
claim are that they left an electric appliance to cook their dinner one Sunday
while they went off to church and when they came home their home was burning.
They called their insurance company to report the fire and were told that
“someone would contact them within 48 hours.” There they were, on the
sidewalk of their destroyed house and their insurance company was of absolutely
NO immediate help. Unfortunately, things just got worse from there.
This family was fortunate enough to have relatives in town with which they
could seek shelter.
After reviewing the site, I created a scope of
repairs using an industry standard estimating program which by coincidence was
the same one that the insurance company used. When my scope was complete,
it was sent to the insurance company and the insurance company simultaneously
forwarded their scope to my company. Imagine my surprise when the
insurance company scope of repairs came in at $82,000 and my scope was at
$350,000. I had visions of being called a scoundrel or of being fired for
gross incompetence. As I looked through the insurance scope, it began to
occur to me that their scope would only cover up damage and not come close to
addressing the problems associated with the fire that had occurred in this
home. During the ensuing weeks, the insurance company suggested to the
policy holder, that we were “gouging” them. In addition, they intimated
that if the policy holder stuck with the notice of claim that we provided,
their claim would be paid slowly and or not at all, their rates may increase
proportionally, even insurance fraud was mentioned. All the time the
insurance adjusters scope left damaged electrical wiring unrepaired, smoke
charged drywall painted over and ruined contents being left out and
undervalued. I watched in disillusionment, as the insurance company stuck
to their position realizing that the paradigm I had held, that the insurance
company would protect its policy holders, (that’s their job right?) faded into
the realization that they would argue to keep the costs as low as possible, so
that they will reduce the cost of the claim. Finally, the owner hired a public adjuster.
Then everything changed. All of a sudden the insurance company was
responsive. Where phone calls took days or weeks to be returned they were
talking to the public adjuster when he called. After months of
stonewalling, payments for undisputed amounts of the claim arrived in the mail,
so that repairs could begin after waiting six months. Then a “large Loss”
adjuster from the insurance company was assigned to the claim. Turns out
that the adjuster the insurance company had making the valuation and scope of
repairs for the claim, didn’t really know anything about construction.
I’m not just saying that she wasn’t or hadn’t been a licensed contractor, she
literally did not know anything about construction or even how the repairs were
to be made to the house. I could not help but wonder how in the world a
large legitimate insurance company could have possibly allowed her to be in
charge of the scope of repair of this family’s most important asset. The
large loss inspector came into town (Phoenix, AZ) from Washington State,
I am not sure why they had to send someone from so far. When we finally
went through the house with the new insurance company adjuster and the public
adjuster, all of the items on my previous scope were accepted, as well as some
new ones that had come to light during the process. The grand total on
the structure only was finally settled out at $362,000. The family told
me that they had come close many times to accepting the insurance company’s first
offer of $82,000. They figured that the insurance company
surely couldn’t be making that big of a mistake, but they stuck to
the course and all ended well for them. The repairs of the home were
finished 5 months later. They received a fair settlement for their lost
items and are now living happily in the same home with their 5
children. They even got paid for their living expenses as their
policy stated. I have no doubt that had they not allowed a public
adjuster to help them negotiate their claim that they would have been cheated
by their insurance company. Maybe you are thinking that this was a
one-time occurrence, but you would be wrong if you did. I am happy to say
that in the last four years it has not happened on all of the hundreds of claims
that I have handled since then, but it happens enough to where it is my opinion
that there is a lot more insurance fraud (if you choose to call it that as I
do) that runs from the insurance carrier to the policy holder than I ever
imagine goes the other way.
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