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Last Post 11/02/2010 6:40 PM by  Roy Estes
Huge Hail
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Kold King
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05/15/2009 8:38 AM
"I do have to say there must be a bunch of bad adjusters out there buying thermal blistering, manufactures defects and circling bird crap as hail. Half or more of my neighbors have gotten new roofs courtesy of their insurance companies for bogus hail damage. It irritates me to see some adjusters buying everything because of greed or they just do not have a clue. It devalues our profession."


The opposite is also true. My dad was a claims manager back in the 60's, and we've been roofing contractors and roof equipment manufacturers for 42 years. Our specialty is negotiating disputed insurance claim where the adjuster has underpaid or denied a legit hail roof claim. I can tell you without hesitation that adjusters get it wrong as often as right. I can't count the times where the adjuster tried to cheat the insured out of a fair settlement, and we got involved and got them what they had coming. One such adjuster on Welch Texas schools paid $3500 for flashing damage - it took me less than 2 minutes to get him to pay $60,000. He knew the damage was there, he was just not going to pay it if he didn't have to. Post Texas schools underpaid by more than $100k, Lamesa schools $120k. I could give hundreds of examples.

One lady adjuster threatened to throw me off a roof in Texas because I wouldn't agree with her opinion that those big holes in a commercial roof were caused by something other than hail. Never mind that the entire town was wiped out with baseball sized hard hail, she maintained that, somehow, this roof was spared and that the holes must have been casused by...I dunno, maybe a meteor shower or some other uncovered peril. Over over over over and over again I've seen the insured cheated.
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MBoy
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05/15/2009 10:25 AM
Keep in mind there are times when adjusters are instructed to "buy" a roof even if there is no damage. My mentor told me of a one time in 1998 in Texas were he was instructed to purchase roofs in select areas of town. He was told the company made the decision to do this to fuel neighboritis and have people switch carriers.
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Kold King
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05/15/2009 11:27 AM

Posted By MBoy on 15 May 2009 10:25 AM
Keep in mind there are times when adjusters are instructed to "buy" a roof even if there is no damage. My mentor told me of a one time in 1998 in Texas were he was instructed to purchase roofs in select areas of town. He was told the company made the decision to do this to fuel neighboritis and have people switch carriers.

 
Which I guess was his perogative. It's another matter when they go the other way and a carrier decides to resist the claim regardless of the damage. We in the roofing business know when certain adjusters or consultants are assigned, the carrier doesn't want to pay the claim.
 
I locked horns with a clown adjuster in Lubbock Texas, named Harley something or other. It was on an 1100 SQR shopping center and the guy was just bizarre in his unprofessionalism. Which defied logic because he is past-president of an area adjuster association. I can't prove it but I think the guy was hired specifically to deny the claim. Never mind that similar roofs less than 100' away were also damaged, the guy went into this very strange almost trance-like behavior and refused to reason with me, or the insured. He seemed to think that pointing out a few very minor installation issues around a scupper, somehow absolved the carrier of responsibility for the hail damage claim. He'd point it out and ask me to explain it, and I'd say "Yeah, that's nice but it has nothing to do with the servicability of the roof or the hail damage you owe for." Every time I'd turn around to show him another large strike, he'd be wandering off again looking for some excuse to blame the roofer.
 
When adjusters like that, with seeming reams of credentials, are obviously trying to cheat the insured, it gives your profession a black eye. 


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ChuckDeaton
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05/15/2009 7:29 PM
I have been adjusting for 35+ years. At some level I have been involved in lots of hail storms, hurricanes and floods and have worked for all of the large insurance companies and lots of little ones, I can truthfully say that I have never, not one time, ever, been told or heard of any other adjuster being told to "cheat" an insured.


"Prattling on and on about being an ass with experience doesn't make someone experienced. It just makes you an ass." Rod Buvens, Pilot grunt
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LENNY
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05/15/2009 9:36 PM
So... Kold King what’s your point? I came from the construction industry prior to getting into adjusting 15 years ago I'm pretty good at determining damage to a roof. I can tell you just as many stories about roofers trying to pull the wool over the eyes of the insured and the insurance company. How many roofs have you looked at for an insured that is challenging and adjustment where the adjuster adjusted the roof correctly? Can you be honest with that response?

Chuck is 100% correct, there is no insurance carrier requiring their adjusters to cheat the insured, bottom line. The adjuster may be inexperienced in evaluating damage. I can assure you the carrier did not instruct him or her to cheat the insured.
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Ol' Ghost
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05/15/2009 9:40 PM
I've been a pure property adjuster for the past 33 years and have never been told to cheat anyone. Indeed, every company has stated to always give the benefit of the doubt as this is one of the Guiding Principals of Insurance.

However, I have personally witnessed loud mouth, arrogantly braying, anal orifice contractors pull all kinds of stunts to intentionally play all sides against the middle to benefit their inherent greed.

Would only that they would stick to performing the repairs and not interfere in the assessment of the loss. It is solely the adjusters function to determine the insurable loss, not some hairball contractor. The contractors function is only say how much he/she/it will charge for his/hers/its services and then actually do the job right the first time.

Ol' Ghost
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HuskerCat
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05/15/2009 11:14 PM
Kold King has given both ends of the spectrum, which are probably true.   But in agreeing with the other posters, those 2 extremes are probably very limited in occurrence but highly retained in memory.  Like Chuck, Lenny, Ghost, etc., I have never been instructed to cheat or shortchange any insured...nor do I know any adjuster (and like those guys, I know plenty over the years) that has been given that instruction or chosen to do so on their own.
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BobH
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05/16/2009 12:23 AM
Posted By Ol' Ghost on 15 May 2009 09:40 PM 
... Indeed, every company has stated to always give the benefit of the doubt as this is one of the Guiding Principals of Insurance. 
If it's gray, you must pay.
I have never been told by any carrier to "cheat" etc. 
 
That is very short-sighted.  It is what it is, and if you don't step up to the plate and pay what is covered and damaged it just doesn't stay a closed claim - no one wants that.

Bob H
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Kold King
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05/16/2009 10:11 AM

Posted By Ol' Ghost on 15 May 2009 09:40 PM
I've been a pure property adjuster for the past 33 years and have never been told to cheat anyone. Indeed, every company has stated to always give the benefit of the doubt as this is one of the Guiding Principals of Insurance.

However, I have personally witnessed loud mouth, arrogantly braying, anal orifice contractors pull all kinds of stunts to intentionally play all sides against the middle to benefit their inherent greed.

Fair question, Ghost. I'd guess that 7 times out of 10 the adjuster knows what he's doing and is fair in his adjustment. Obviously no carrier/agent is reckless enough to come out and tell an adjuster to underpay or deny a claim.

 
There are numerous adjusters in this part of the world who have a reputation of skimping on payment. Just as y'all have admitted that an agent sometime subtly suggested that roofs/customer be bought when no damage exists, the same subtlties tell us when an agent/carrier doesn't want to pay a claim. I won'y mention the name of a well known engineering firm or a handful of roof consultants, but you can be assured that when they get involved they will attempt to cheat the insured. Their reputation is well known, and the fact that they never err on the side of the insured tell you that incompetance isn't the issue with them.
 
Would only that they would stick to performing the repairs and not interfere in the assessment of the loss. It is solely the adjusters function to determine the insurable loss, not some hairball contractor.
 
You wish! The adjuster represents the agent's interest and the roofer represents the insured. That's the way it is and it's disengenuous to suggest otherwise. My dad was a claims manager - adjusters are there to control claims, not to hand out money. Agents work very hard to protect their loss ratio.


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Kold King
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05/16/2009 10:24 AM
Using the example of crooked roofers to establish the honesty of adjusters doesn't fly. I know the ratio of crooked roofers to good ones is a lot worse than for crooked adjusters to honest ones - I admit that readily. But a crooked adjuster is in a position to do a lot more damage to the insured than a crooked roofer is in a position to damage a carrier.
 
We're not talking about vague situations where the damage and coverage is not clear cut. I'm talking about the hundreds of times I've been involved when the adjuster just flat refused to budge on obvious damage. FWIW, when that has happened, and when the insured agrees with my recommendation, we take it to arbitration/mediation/appraisal. We've only lost one of those in the last 28 years, and that was because I failed to have input on the Third Disinterest Party choice. And that alone shoots down the silly notion that the roofer has no b usiness being involved in the claims procress. The insured rarely knows his options under his policy. Trying to kick the roofer out of the process is akin to leaving the fox in charge of the hen house. It ain't gonna happen!
 
And btw, trying to disallow the roofer in the claims process shows ill intent. Our standard advice when asking our customer to turn in a hail claim is: Insist that the adjuster contact us to look at the roof with him. Fifty percent of the time the adjuster will ignore this and come out by himself anyway. If he does this, refuse to let him on your roof without us present. It is your right and it is in your best interest.
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Ol' Ghost
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05/16/2009 12:23 PM
That's a lie. I will not allow any outsider to spew such drivel in the mine or any of my other distinguished professionals presence. I can now guarantee any future contacts with you or your ilk will be in an adversarial venue.

Ol' Ghost


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Tom Toll
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05/16/2009 2:11 PM
Posted By ChuckDeaton on 15 May 2009 07:29 PM
I have been adjusting for 35+ years. At some level I have been involved in lots of hail storms, hurricanes and floods and have worked for all of the large insurance companies and lots of little ones, I can truthfully say that I have never, not one time, ever, been told or heard of any other adjuster being told to "cheat" an insured.

I agree with Chuck on this one. In all the years I have adjusted losses, inclusive of all types of losses, I have never been asked to cheat an insured out of a covered cause of loss claim. I have met some very unscrupulous roofing contractors. Fortunately, there are also honest roofing contractors. I have inspected and measured thousands of roofs in my life as an adjuster and have made a few bad calls. I appreciate an honest, tactful roofer bringing this to my attention. I do not respect a roofer who says my 47 squares is incorrect and that it should be 60. Then when I ask him to send me his diagram he tells me he just knows how many squares due to his many years in the business. I can get pretty darn close by guessing how many, but guessing is not a part of my commitment to a vendor or company.
 
Measuring a roof is not rocket science, just laborious in nature and sometime dangerous on steep roofs. I have no intention of arguing with you Mr KoldKing, as that generally only precipitates a delusion of the truth and factual evidence.
Success is not final, failure is not fatal: it is the courage to continue that counts.
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BobH
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05/16/2009 8:56 PM
Posted By Kold King on 16 May 2009 10:11 AM
... My dad was a claims manager - adjusters are there to control claims, not to hand out money. Agents work very hard to protect their loss ratio.
Dude, you are like the TV news person that seeks out the bad news for headlines.
The agents I see associated with claims want to see good service, to fulfill the Insuring agreement.  It's the best advertising there is.  Lots of agents in Texas especially during IKE took matters in their own hands and settled claims directly with the Insured, had their local authority raised by the carrier so people would get serviced as quickly as possible.  From what I saw, most of them were very generous.

Feel free to find a roofers forum where everyone will agree with you, it ain't gonna happen here.
Bob H
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HuskerCat
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05/16/2009 10:57 PM
KK's dad was a claims manager in the 60's...maybe that says a lot more than most of us know.  What we do know, is that the myth still exists that the adjuster is "out to screw you".  I was still in diapers back then, but that may have been the norm for all I know.  Perhaps KK needs to bury the past, and see it for how it really is today without having preconceived notions.     
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Kold King
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05/17/2009 8:17 AM

Posted By Ol' Ghost on 16 May 2009 12:23 PM
That's a lie. I will not allow any outsider to spew such drivel in the mine or any of my other distinguished professionals presence. I can now guarantee any future contacts with you or your ilk will be in an adversarial venue.

Ol' Ghost


What's a lie? It might help if you at least make an attempt at refuting something I said rather than calling it a lie, then giving up in a tantrum.
 
What you said about adversarial though is ironic. Many many years ago I adopted a policy with that word in it. I assume each dealing with the adjuster is going to be adversarial. Doing so avoids the wasted time when I assume the adjuster is being honest with me, but in reality just doesn't have the nerve to tell me he's going to reject the claim while we're both on the roof. Often he will do that from the comfort of his office via fax or e-mail. Thus, my "policy" is to insist that if we're going to disagree about the extent of damage, we're goin to do it right there on the roof where we can see the damage.




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Kold King
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05/17/2009 8:31 AM

Posted By HuskerCat on 16 May 2009 10:57 PM
KK's dad was a claims manager in the 60's...maybe that says a lot more than most of us know.  What we do know, is that the myth still exists that the adjuster is "out to screw you".  I was still in diapers back then, but that may have been the norm for all I know.  Perhaps KK needs to bury the past, and see it for how it really is today without having preconceived notions.
 

It's true that I get involved mostly when a claim is disputed, and thus my view may be skewed slightly. That said, even today, there is no shortage of work for a guy who specializes in disputed hail claims. We don't create claims that don't exist - we spend way too much of our time and effort documenting the damage, conducting infrared scans, and writing the reports, for it to make sense for us to waste our time on a claim we aren't 99% sure we can win. If we get involved, it's a legitimate claim.
 
Ol' Ghost thinks I've cast ill on a respected institution. Well, in that regard you're just like roofers in that you'd do yourself a favor by outing the many many bad adjusters, rather than pretending they don't exist. I've been around the block enough times in my 28 years in the industry to not believe everyone who says that the adjuster is always the insured's friend and whatever he pays for is fair. The millions and millions we've secured for the insured, above and beyond what the adjuster wanted to pay, is millions and millions of dollars that would have been cheated from the insured otherwise. So please spare me the sermon about roofers being the problem and the adjusters being the sainted solution.
 
I have little doubt that I'll be booted from this group in short order. It's obvious y'all aren't interested in any opinions that aren't favorable.    


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Kold King
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05/17/2009 8:39 AM
I was working a storm in Lamesa Texas in '88, a town where we had 75 commercial roofs on including about 350,000 sq. ft. on the schools. As I'm measuring roofs I'm conscoius that an adjuster is doing the same on several roofs just across the alley. Later on he catches me on the ground and askes me: "Hey, I'm an adjuster from Arizona and I've never seen hail damage on a roof; can you show me what hail damage looks like?"  The guy was out adjusting and paying claims and had never before seen a hail damaged roof!
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BobH
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05/17/2009 8:55 AM
Posted By Kold King on 17 May 2009 08:39 AM
I was working a storm in Lamesa Texas in '88...
Thank you for dusting off that treasured memory from 21 years ago.
Excuse me, I have some more hail claims to pay today...

Bob H
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ChuckDeaton
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05/17/2009 9:25 AM
Again, my two bits worth, as noted I have been in this business since some were in diapers and I can unequivocally say that I have never had any hint that anyone, company, vendor, other adjusters, neighbors, whatever, did not want the undisputed amount of a covered claim paid.

Anyone who knows anything about the legal process and climate, as it applies, knows that insurance contracts, for the most part are contracts of adhesion and are allegatory(sic) in nature. The law of ambiguity applies. That is ambiguous portions of the contract are interpreted in favor of the insured.

Crooked roofers, in 35 years I have seen lots, incompetent roofers doing anything to sell the product they are pushing, yep, lots. Second and third inspections because the roofer has a deal that he gets paid what the insurance company pays and refunds the deductible, yep, lots. Roofers with office girls who use internet satellite measurements and are paid to hassle the hell out of the company, yep. The roofing business is a genuine snake pit of questionable and crooked characters.

Self righteous roofers, yep, BobH, Tom Toll, ChuckDeaton, we all use our given names, roofers, no, Kold King. God forbid you were stuck with that name at birth.

I love roofers, Kold King types, sit in the back of the room, get a high school certificate types that think they know more about roofing than Professional Engineers, engineers with graduate degrees from real universities and a P.E. stamp that have done the necessary research.

Geez, Kold King spend your time getting on those roofs and arguing over a speck of bird crap or granule loss. And if you can't convince the adjuster that bird crap is hail damage then tell the insured that the adjuster is crooked, the engineer is crooked and turn the claim over to Mary Lou in your office to get the satellite measurements and call the company 5 times a day. And if that doesn't work put the claim into appraisal.

Well, looks like I lied, that was five cents worth.
"Prattling on and on about being an ass with experience doesn't make someone experienced. It just makes you an ass." Rod Buvens, Pilot grunt
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Ol' Ghost
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05/17/2009 10:03 AM
I suggest this page of this topic be purged and Kold King be banned from this web site.

Ol' Ghost
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