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Czar

USA
66 Posts

Posted - 03/28/2004 :  12:22:59  Show Profile
rbickel:

The problem that has occurred in the area is that most adjusters and roofers alike in central Ohio just don't understand how to evaluate hail damage, due to the lack of experience with it. Most adjusters and roofers that I have met with want to point out denting to soft metal (gutters, downspouts, vents). I had one roofer tell me that there was no reason to even get on the roof becasue the homeowners screens and a/c fins were dented. Sure enough we got on the roof and he could not point out one single hail mark on the roof covering.

A claim that I had ran into last year involved a house that is located on the east side of Westerville. I met with the insured and she stated that everyone in her neighborhood has had a new roof. I looked around and sure enough every roof was brand new. At the time, I lived in the same city and was skeptical of any damage as I witnessed the small hail in the area. The roofer, had informed the insured of the damage to her roof, and showed up 5 minutes after our conversation. He informed me that they had done all eight houses on the block. With that I got up on the roof with him and asked him to show me the damage. After about 20 minutes on the roof, he was only able to show me 4 marks on the entire roof, that at best were questionable "damage". He then informed me that he had never really inspected the roof and just assumed that I would pay for the roof since the bid company in central Ohio had bought all of the neighbors. Make your own conclusions as to what happened on the neighbors roofs with their adjusters.

As for your contractor, they have a long standing business in Ohio and I would never bad mouth a contractor in public, but as someone up above mentioned, try to find someone you know and trust to inspect your roof, because although your contractor is local there is a reason that they are the largest in the area. If they say yes they feel there is damage to your shingles then ask for the re-inspect.
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Tuckernotis

USA
19 Posts

Posted - 04/14/2004 :  12:35:41  Show Profile
I just went through this. I wanted to post an update but the thread has been locked. Call for a second inspection. Become educated yourself on what is and what is not hail damage. Try searching for "Haag hail damage" on Google. The first time the adjuster came out (he is not an independent), he didn't even get on the roof. He said, everything looks fine. Sssuuuurrrreeee. Well after I was armed with knowledge and the generous time of one of the adjusters from this board, I called him back. Sure enough, I'm getting a new roof. So is everyone in my neighborhood. It's the old game, if 10 people call and 5 are told they don't need a new roof, the odds are some will not bother calling back thereby giving the insurers a break. Call him back out with specific information, not necessarily from a roofer. Be an informed consumer. Not all adjusters are looking out for the insurance companies' interest but some are. That's life.
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Kevin Kramer

USA
4 Posts

Posted - 04/16/2004 :  09:31:20  Show Profile
An attempt to enlighten with a statement and a question.

Firstly, "Appraisal" is used to determine "amt. of loss" - primarily $ amt. of undisputedly damaged items however, is not used to establish loss itself. That would be "Arbitration" and no homeowners policy that I have ever read has guaranteed that arbitration will be provided once it is requested. It is a tool of sorts used by the insurance industry (as a customer courtesy gesture of fair-play), more often than not paid by the insurance industry ($800.00 "Binding" or $400.00 ea. "Non Binding"), and overwhelmingly resulting in favor of the insurance industry (and not because of any bias, Arbitrator is truly a neutral 3rd party). For those of you who have not tried "Arbitration" , I would highly recommend it, as it will refine the way you call and defend your roof inspection findings. With all this in mind I feel it important to note that as a customer service agent, My abillity to accurately identify storm damage is as important as my abillity to convince an insured (although not always possible) of no damage when they truly have none.

Oh Yes, My Question.

Why would an insurance company, an entity with a clearly identifiable intrest in the wellbeing of a building and its contents, seek to deny real storm damage to any roof, the most important and least expensive external barrier to internal (real $) damage?
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KileAnderson

USA
875 Posts

Posted - 04/16/2004 :  11:35:48  Show Profile
Kevin, your last question is the one I always ask when all else fails. But usually by the time I have to pull that one out the insured is completely unreasonable anyway.
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olderthendirt

USA
370 Posts

Posted - 04/16/2004 :  12:36:45  Show Profile
The insursnce company as an entity would never real storm damage, but in most organizations are people who feel that they have to save every $ no mater how. I have on occassion seen cat adjusters in glee over dening a loss. And many times I have meet company people who take joy in denying, and only grudgingly pay when forced to. This attitude created bad faith and PAs.
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Wes

USA
62 Posts

Posted - 04/16/2004 :  13:37:11  Show Profile
Can anyone explain why there seem to be two types of adjusters in regards to the previous posts? I have certainly witnessed this in my short adjusting career. There are the adjusters who go out of their way to look for any possible coverage to a loss and on the completely opposite end there are adjusters who arrive on the property looking for any possible way of denying coverage. I personaly have felt that you should do anything possible to find coverage in the policy even if its a stretch of the policy language and then if that fails you have a obvious denial. One of my observations pertaining to this is there seems to be a difference in staff trained independent adjusters as opposed to adjusters that have always been independents.
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KileAnderson

USA
875 Posts

Posted - 04/16/2004 :  13:41:14  Show Profile
I have no idea why anyone would approach a loss looking for a denial. It is alot easier to pay a claim than it is to deny it in most cases. Who doesn't like to get a check? I think alot of newer adjusters are gun shy and afraid to pay claims because they don't want to get in trouble for paying for a claim that isn't owed. I have heard from several managers that they would rather I make a mistake and pay a claim that isn't owed as opposed to denying a claim that should be paid. In the end it probably all comes down to the individual. Some people are just mean.
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Wes

USA
62 Posts

Posted - 04/16/2004 :  13:57:35  Show Profile
Yes I agree with that coverage decision mistake thing. It will be a much bigger bite out of your butt if you deny a claim that should have been paid as opposed to paying a claim that should have been denied. A unhappy insured that has been wronged can bring the heat on big time for the adjuster, the insurance company and the adjusting company. If you mistakenly pay a claim that should have been denied a reprimand is in order for the adjuster and thats about the end of it unless of course there is a pattern developing that needs to be addressed.
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DEMIGOD

99 Posts

Posted - 04/16/2004 :  23:58:04  Show Profile
Czar how silly for that salemen to think you'd pay for the roof just becuase. He has no clue!

Wes,
Man I could not identify with what you say about adjusters. I meet with some they act like the money is coming out of thier own bank account, and in many cases those are not the new young buck adjusters, perhaps they are acting like that towards me becuase of all the crapy and stupid contractors he's dealt with for years upon years.

Then thiers the adjuster who I meet and he's really in my opinion acting exactly like how I believe an adjuster should. He's looking for any and all possible reasons to find a valid reason to pay a claim. Anything thing he deems as questionable he rules in favor of his insured's best interest and not the carrier's. But really when it all somes down to it, isn't it your responsibility to act like a fudiciary and allways but the best intrest's of your insured over your own as long as your not breaking the agreement as set forth in the policy? Perhaps those other guys acting like their no damage or saying crap like, that copper dormer is only dented it's not damaged has lost sight of the core values and principals that set forth his guidlines of conduct for holding such a entrusted position as to indemnify some one.
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olderthendirt

USA
370 Posts

Posted - 04/17/2004 :  01:02:21  Show Profile
I was raised with "the benefit of the doubt goes to the insured". Today I find many feel that it is to their benefit to doubt the insured.
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DEMIGOD

99 Posts

Posted - 04/17/2004 :  01:16:52  Show Profile
Jesus Christ indemnified, are you gonna make a claim? Does that make any sense at all? spam? Just a thought
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leoncrow

USA
16 Posts

Posted - 04/17/2004 :  08:32:24  Show Profile
They don"t pay you to go back. Do your best to close claim first time.
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Kevin Kramer

USA
4 Posts

Posted - 04/17/2004 :  09:56:37  Show Profile
Property adjusters are forced to fulfill many roles but probably none more important than that of a salesperson. Of course we should approach every claim from the perspective of finding coverages and give the benifit of doubt to the insured. Adjusters who are not consistantly finding coverages that the insured did not expect are not true customer service agents. It's easy to get a bad attitude about contractors and policyholders when you come across (and vividly remember) so many crooks and liars. Poor attitude, skepticism and emotion will destroy your attempts to sell the insured on even the most accurate of inspection findings. It took me a few storms to figure that but but what a difference it has made after I did.
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olderthendirt

USA
370 Posts

Posted - 04/17/2004 :  11:03:19  Show Profile
"so many crooks and liars" Is that how you have been trained to view the policy holders?
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DEMIGOD

99 Posts

Posted - 04/17/2004 :  11:56:27  Show Profile
Speaking of the insured. Like you I have dealt with many and perhaps what kevin might be eluding to is that particular home owner that's not saying and doing the norm that you find from the every day person filing a claim.

Like I know in the first minute or so if a homeowner is attempting to make money on a claim by beating up a bunch of contractors to see how much money he gonna have left after he pays for his work. You just know after time by the questions they ask or what they say, or even thier body language thier out to see how much they get to keep.

At that point if I suspect this I just come right out and ask them, are you trying to see how much your going to have left over? Becuase if you are I won't be a party to that, it's fraud and anything left over should go back the your insurance company. They usually back peddle at that point and deny thier true motives, of which I have exposed so bluntly. At that point thier mine if I choose to let them do business with me. Their guild of being so dishonest they usually can't wait to sign up to try and recover thier sins! lol.

But usually I just end up saying something stupid or giving them an outragously high estimate without measuring anything of course. So they never call back and I don't have to deal with them. To bad you can't do that kevin! haha.
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