Insurance questions (1 Viewer)

[sonicboom]

I’m surprised that as great a job this forum has done at crafting long detailed threads on wrestling to music to why the Foo Fighters Suck, there isn’t a thread dedicated to insurance questions.

Given the wealth of experts who work in the industry to those who have filed insurance claims in the past, I had a couple of situations occur at home recently that I could use insight on.

We had a pretty nasty storm two weeks ago and our home sustained water damage. Our roof is built at a weird angle, and water found a way in. The roofer came out to check the roof that they installed 9 months ago, and they didn’t find any holes, but they pointed out how the water got in, and there was nothing they could have done at the time of the roof install unless we made a change to the structure of the home.

Foo Fighters still suck!

Insurance folks are coming out next Monday morning, fingers crossed we don’t get any nasty storms before then.

@efil4stnias thanks for your insight.

Best of luck to you.

I wish I could be more of a help, but if it was me, I would see if the insurance company and the roofer's opinion match up, then go from there.

 

[DaveXA]

Lot to unpack there. I dont come from claims side, nor have i read your policy, so it will be tough to give you valid answers.

In general, the first thing that needs to be determined is proximate cause. What "caused" the water intrusion? That is the key to all of it. If the "cause" of intrusion is NOT a covered peril, then chances are the claim will be denied.

From your description, it sounds like your roofing system isnt common and was the root cause of the water intrusion. Just based on that description, that wouldnt be a covered peril ( design aspect of roof system ) unfortunately.

But it never hurts to file claim and allow adjuster to do his thing and submit to carrier.

One of the more litigated aspects of storm related claims is "wind driven rain". Wind forces push "up" on roof eave, lifting it ever so slightly, allowing for wind driven rain to seep thru opening. Many policies today exclude this event.

Yep, I worked for an attorney and he represented an insurance company and I'd basically prep documents for cases dealing with insurance claims from storm damage from Katrina and Rita. Most were cases related to homes and property damaged by Rita and there were so damn many cases. It was just one after the other every day all day for months. And a lot of them were basically the policy holder and insurance company arguing over what caused the damage, wind, rain, flood among other things, like what's covered property. It was really interesting reading the cases and the arguments made by both sides.

The wind/rain/flood and what precisely cause the damage made the difference in whether it was considered a covered loss or not, not to mention if the property was already in poor condition or some situation made the damage possible or worse than it could have been.

So circling back, its going to come down to how the water got in to home in first place. The cause HAS to be a covered peril. Age, deterioration, design arent covered perils in an insurance policy. So if it is related in any way to any of that, chances are they will deny the claim.

I would probably reach out to your agent to discuss your concerns as he would be the most reliable source - after all, he is an Allstate agent.


good luck!

 

[DaveXA]

@efil4stnias (or anyone else) in a lease to own housing situation, who carries the insurance responsibility?

I'm not an insurance agent but I did stay at a Holiday Inn Express.

In a lease to own situation, I would think that the owner would be responsible for homeowner's insurance on the property. Of course the tenant should carry renter's insurance to cover personal property in the dwelling.

 

[El Caliente]

Foo Fighters still suck!





Best of luck to you.

I wish I could be more of a help, but if it was me, I would see if the insurance company and the roofer's opinion match up, then go from there.

Turns out insurance denied my claim as the damage sustained from the water was caused by the flashing on my roof not being high enough (it’s a weird build).

The roofer isn’t taking any of the blame either as the project manager said “I’m sorry that I didn’t catch that when we built your roof. We can come back out and add the flashing, but it would require us to rebuild that part of your roof, and we only redo roofs, we don’t build homes.”

 

[sonicboom]

Turns out insurance denied my claim as the damage sustained from the water was caused by the flashing on my roof not being high enough (it’s a weird build).

The roofer isn’t taking any of the blame either as the project manager said “I’m sorry that I didn’t catch that when we built your roof. We can come back out and add the flashing, but it would require us to rebuild that part of your roof, and we only redo roofs, we don’t build homes.”

To me it sounds like the roofer is to blame and he is of course trying not to look like it's his fault. Maybe talk to Chucky, another lawyer or two, get a quote from a different roofer to see how much it will cost to fix the roof, and see if you can get the guy who did your roof, to do it right the second time, or get your roof fixed, and take the contractor to court (If a lawyer thinks you have a case).

I'm surprised the roofer wasn't more willing to fix it. Isn't flashing what roofers install??? My old home I had a new roof installed, a few shingles sorta dislodged, and he fixed it for a small fee. Maybe ask the roofer how much he will fix it for, and if it's reasonable, call it a learning experience?!?!

I'm not a lawyer, but it definitely sounds like it's the roofer's fault, from the information you presented. People make mistakes, so it's probably best to see, if you and the contractor can just settle this out out court. This is just my opinion, I don't know the whole story, but I hope it works out.

 

[bclemms]

Did the roof leak prior to the roof being installed? Did the roofer inform you of this design flaw when selling you a new roof or only after the failure of this roof and his responsibility to warranty and repair?

 

[El Caliente]

Did the roof leak prior to the roof being installed? Did the roofer inform you of this design flaw when selling you a new roof or only after the failure of this roof and his responsibility to warranty and repair?

No, it didn’t leak until the most recent storm in May. When I called the roofing company they said “yeah, we didn’t realize that due to the design of your home that we would need to add more flashing.”

 

[efil4stnias]

@efil4stnias (or anyone else) in a lease to own housing situation, who carries the insurance responsibility?

From my experience, it will hinge on the language in the lease.

It should designate who is responsible for what.

Technically you don't get title to home until lease is up. So unless the lease specifically says you must insure property, it would be the lessor. And if you are lessee, you would need a "renters" policy for your liability and content (and all the other ancillary coverages that come with like additional living expense ).

 

[efil4stnias]

Turns out insurance denied my claim as the damage sustained from the water was caused by the flashing on my roof not being high enough (it’s a weird build).

The roofer isn’t taking any of the blame either as the project manager said “I’m sorry that I didn’t catch that when we built your roof. We can come back out and add the flashing, but it would require us to rebuild that part of your roof, and we only redo roofs, we don’t build homes.”

So a roofing co is saying they don't know how to rebuild a roof??

I'm confused now....did they just reroof and missed the flashing install or rebuild your roof ( rafters, decking, flashing and shingles)?

If the project manager said "sorry we didn't catch that issue" then it could be construed as a liability issue for them and their insurer.

You may want to speak to an attorney if they aren't willing to repair roof and your interior damage at their cost. If they are insured, that may be the route your attorney takes if they refuse liability ( but would imagine his statement to you indicates they know they did something wrong by overlooking this flashing issue)

If they carry a General Liability policy, it may be an avenue for you. But much will depend on policy language and a host of other things.

Speaking to an attorney is probably best.

Wish I had better advice.

 

[bclemms]

No, it didn’t leak until the most recent storm in May. When I called the roofing company they said “yeah, we didn’t realize that due to the design of your home that we would need to add more flashing.”

Yeah, you're going to have probably go straight to lawsuit against the roofing company. Try to get them to email you a response so you have something in writing stating the above.

 

[Consigliere]

I know the Rainmaker movie is fiction, but i have no doubt insurance companies have a policy to deny some claims just to see if the client just gives up the fight.

No insurer has that policy. It would be legal, financial, and regulatory suicide.

However, you do get lazy or aggressive individual adjusters. Lawyers love those guys.

 

[Consigliere]

Yeah, you're going to have probably go straight to lawsuit against the roofing company.

If you go this route, emphasize the damage to property other than the roof they built. Their GL policy will not cover the need to redo bad work, but it will cover resulting damage to other property.

 

[GeauxWhoDats]

No insurer has that policy. It would be legal, financial, and regulatory suicide.

However, you do get lazy or aggressive individual adjusters. Lawyers love those guys.

To add to this, with all of the recent mass layoff, terminations, forced retirements that we see in the industry, disgruntled whistle blowers would be coming out of the woodworks.

 

[DaveXA]

To add to this, with all of the recent mass layoff, terminations, forced retirements that we see in the industry, disgruntled whistle blowers would be coming out of the woodworks.

While that may be true, I'm sure there are NDAs and threats of being blackballed in the industry not to mention potential legal action. If they're gonna blow the whistle, they better have all their ducks in a row before they do blow the whistle. I'm not sure what kind of whistle blower protections the industry has tho. The bigger insurance companies have insanely deep pockets, so they can afford to litigate this when need be. Whistle blowers often don't have that kind of money.

 

[GrandAdmiral]

So, is deregulation the answer to Louisiana's insurance problems?

Louisiana Insurance Commissioner calls for special session

Some homeowners say they are going without insurance, as insurance commissioner calls for special session

www.fox8live.com