How to Get Your Insurer to Pay Your Frankenstorm Damage Claim

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Home flood damageSo, let's assume you did the right thing in getting insurance to protect yourself against those times when Mother Nature comes knocking. Well, if you live on the Eastern Seaboard, it looks like she'll be banging on your door early next week, and this time, she's bringing Frankenstorm.

This rare hybrid of three big weather systems could be a challenge for your emergency plan. But it's after Hurricane Sandy blows through that you may face the real challenge: Getting your insurance company to pony up the cash instead of trying to deny your claim.

As J. Robert Hunter, director of insurance for the Consumer Federation of America and former federal insurance administrator, noted in connection with Hurricane Irene last year: "Families will have to dig deeper into their pockets, because insurers have been steadily increasing hurricane wind coverage deductibles and imposing other policy limitations."

"This liability shift to consumers may take some by surprise, since disclosures are often buried in renewal paperwork that consumers may not understand or even read," he said.

"We urge homeowners dealing with losses ... to be vigilant with their insurance companies to ensure that that they receive a full and fair settlement," concluded Hunter.

All still good advice.

How to Boost Your Odds of Getting Paid

The names of the storms may change, but what you need to know doesn't. So, let's look back at the advice we first offered back when we were reeling from Hurricane Irene, from DailyFinance's Sheryl Nance-Nash, because if you want to increase the likelihood that your insurer writes that check, there is much to do.

Don't dillydally when it comes to reporting your claim: Insurance companies generally handle them first come, first serve, warns Hunter.

Once your claim is reported, get your claim number and write it down. Having that number will make your life -- and the insurance company's -- easier.

Find out a little about the adjuster who will come to your house to assess the damage. You want to know if he is an employee of the insurance company or an independent adjuster hired by your insurer. The answer matters: If the person is independent, get the name of the actual insurance company adjuster whom the independent adjuster is sending your information to, and find out whether they are authorized to make claim decisions and payments on behalf of your insurance company.

Beware of firms that demand up-front fees for services, regardless of the outcome they negotiate on your behalf with the insurance company. Public adjusters work purely on a contingency basis, ensuring that a homeowner does not pay anything unless he or she receives some form of settlement, said David Charles, president of Catastrophic Claims Consultants.

Build Your Evidence

Anticipate the possibility of push-back from the insurance company, and be ready to hit them with documentation. When you file a claim, CFA advises immediately starting a notebook detailing all your contacts with the insurance company. List the date, time and a brief description of what went down. If you need to amplify later, this will give you a leg to stand on. If an adjuster says he or she will not come out, for example, write it down. If an adjuster is a jerk, note that too.

You own a ton of stuff. Make a list of it all. Better still if you took photos of your possessions before the storm, but If you didn't, don't sweat it. "Those snapshots from a party may offer proof of your TV that was destroyed, or the rug that was ruined," said Phillip Sanov, an attorney with The Lanier Law Firm.

Do, however, take photographs of the damage before doing any repair work to your home. Also, make an itemized list of all damage sustained during the storm and its aftermath, advises Frank Keaney, who specializes in homeowners insurance with Amity Insurance. Do all you can to minimize secondary damage: Your homeowner's policy requires that you "mitigate damage," said Kevin Lynch, an assistant professor of insurance at The American College.

You'll want to do some homework by getting a repair estimate from a contractor to help you in talking with the adjuster. Hang on to receipts for any emergency repairs, and costs such as if you have to stay in a hotel. This may be reimbursable under the "additional living expense" portion of your homeowners' policy, said Keaney.

If needed, you can use weather data provided by the Forensic Weather Consultants at www.weatherconsultants.com, a company of forensic meteorologists who can substantiate hurricane based insurance claims.

It should go without saying, but be honest. Claim inflation invites claim denial, said Michael Huber, partner with the law firm of Ver Ploeg & Lumpkin.

Fight Back

Make sure you follow up on your case: Don't just file the claim, sit back and wait for your payment. Check in regularly with your insurance agent or company on the progress of your claim, said John Egan, managing editor of InsuranceQuotes.com.

If your insurer denies your claim or offers a piddly amount, don't just accept it. CFA advises demanding that the company identify the language in your homeowners' policy that served as the basis for denying your claim or offering so little. The company may be right and you may not know it. Once the company pinpoints the key language in the policy, you should be able to make this determination. Then too, it could be that the company has craftily put new limitations into the policy and didn't make them clear to you. If you feel misled, weigh whether you want to contact an attorney.

For example, said Hunter, the introduction of percentage deductibles (up to 10% of the value of a home), will greatly shift the cost from insurance companies to consumers. The practice of shifting the cost of previously insured events back to consumers is acceptable, as long as consumers are clearly given the option to select the level of coverage they want with fully informed consent.

Another new way insurers can pull a "gotcha" is by putting a limit on replacement cost payments, which might come into play in the event that a home is totally destroyed. A typical cap is 20% above the face value of the policy. According to CFA, if costs surge because of the spike in demand for materials or labor following a major storm (or if the state does not monitor price gouging sufficiently) this limit might apply. For example, if a home was expected to cost $200,000 to replace and that amount was the limit on the policy, the insurance company would pay no more than 20% more, or $240,000. If the surge in construction costs due to extreme demand caused the price of replacing the home to jump to $300,000, the homeowner would be short $60,000.

Know Your Rights

The squeaky wheel gets the grease. Do complain to the powers that be in the insurance company if you feel like a denial was unwarranted or the reimbursement too little. Don't stop there. Complain to your state insurance department: It will make an inquiry with your insurer. See a lawyer if you want to take it a step further.

Once the insurance company tells you the reasons for its action, it legally can't produce new reasons for denying payment or making a low offer at a later time. You have locked them in -- a major advantage for you.

If you review the policy and find that, without stretching your imagination, it seems plausible that you should get the full amount of your claim, you will likely win if you go to court. The CFA notes that courts consistently rule that if an insurance policy is ambiguous, the reasonable expectation of the insured party will prevail since the consumer played no part in writing the language of the insurance policy.

Expect the worst, but hope for the best. Said Hunter, "Not all insurance companies handle claims badly, so go into the claims process with an open mind. Be vigilant though, or you run the real risk of being shortchanged."

More on storm preparedness:
Hurricane Sandy the Frankenstorm Is Coming: Do You Have Flood Insurance?
How to Protect Your Home From Damage in a 'Perfect Storm'
How to Avoid Home Repair Ripoffs After Frankenstorm Passes



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24 Comments

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billcac

From a Sandy casualty. This article relates to insurance that covers hurricane damage for wind and sewer back up and even that they'll fight!

November 13 2012 at 3:38 PM Report abuse rate up rate down Reply
rep613

Actually, you do NOT have to be in a flood plain or "high risk" flood zone to purchase flood insurance. ANYONE can purchase flood insurance as long as your community participates in the National Flood program.

With that said, yes, it's truly sad that a LOT of people do not have flood insurance. Your homeowner insurance does NOT cover for flood- ONE exception is if you carry a water/sewer backup and sump pump failure endorsement, and even with this, it's usually a limited amount of coverage. (generally about 5k to 10k only).

I pray for relief for these folks!

October 31 2012 at 10:02 AM Report abuse rate up rate down Reply
clinton

If you have damage and have a claim,it should be simple stoopid!

October 30 2012 at 10:45 PM Report abuse rate up rate down Reply
jerrym930

In 2002, I was transferred to Houston from Westlake, Louisiana. The young lady who purchaced our home in Westlake suffered significant damage during Hurricane Rita. Her Insurance Company used a contract adjuster on her claim. In his report, he blamed most of the claim damage on the house settling. The house was over 40 years old and had settled about all it was going to settle.

She called me and asked if I had done an inspection when I sold her the house. Of course, I told her it was the buyers responsibility to do the inspection. I also informed her that since the company paid for my relocation, they had hired Prudential to oversee that process. Basically, Prudential bought my house and then sold it to her. Prudential had made an inspection, and I gave her their phone number.

She called them and asked if they still had that inspection report on file, since it was 4 years later that Rita hit. They did have it and were more than happy to send it to her, including copies of all the pictures they had taken. When she presented this to her insurance company, they were more than happy to cover ALL her damage as being caused by Rita.

This article hits the nail on the head as far as adjusters go. They are there to help the insurance company pay as little as necessary.

October 30 2012 at 9:14 PM Report abuse rate up rate down Reply
gelewis

I believe most home owners insurance at lease in Florida do not cover floods, that is typically a different policy. I wonder how many hurt by Sandy had flood insurance?

October 30 2012 at 8:16 PM Report abuse rate up rate down Reply
kolblh

I sure hope they learned some lessons from Katrina. It was a big pay day for a lot of people. Fraudulent claims mixed with crooked adjusters. The Red cross hired locals to help distribute to those entitled for help, they included their relatives and friends who didn't even live near the effected areas. Fema trailers, police taking what they wanted from the abandoned homes, transporting flood victims to other states, charging way above the fair cost. A nightmare of grief. Where there is a disaster there will be thiefs to cash in.

October 30 2012 at 7:27 PM Report abuse +1 rate up rate down Reply
deexciter

I lost my home in a landslide. It amounted to nearly a million dollars. The casualty loss deduction has only a one year look-back as well as the current year of loss. No help there. Your only help is FEMA and SBA (if applicable). But try to have a pre-disaster appraisal and an inventory with contents (if possible). I always now take current pictures of my home and store them off-site. Make sure you file that appropriate forms with FEMA within the time frames allowed. When all was said and done, it took me a little over 7 years to resolve all of the complexities including the lender, the IRS, credit reporting bureaus and other loose ends. You are about to embark on a journey that few have gone done and even fewer would wish to go down. Good luck.

October 30 2012 at 5:31 PM Report abuse +1 rate up rate down Reply
progressivehoax

Perhaps Obammy will pony up.

October 30 2012 at 4:16 PM Report abuse -1 rate up rate down Reply
forvr22

This article only covers wind damage, this is not the majority of damage from this storm. Most Sandy damage will be from flooding which is a whole different thing. You must have separate flood coverage, and can only obtain flood insurance if you are in a flood plane.
One avenue of relief is casualty loss on your federal taxes. If you pay a substantial amount of tax, you may get some help there.

October 30 2012 at 3:42 PM Report abuse +1 rate up rate down Reply
deexciter

Ask Katrina homeowners about being paid. If you have no flood insurance, then you are S.O.L. It's that simple.

October 30 2012 at 3:27 PM Report abuse rate up rate down Reply