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sue36_gw

Insurance question - fighting their estimate of damages

sue36
16 years ago

This is OT re: selling a house, but I figured this forum was closest. My MIL had a huge tree fall during a spring storm. It totally destroyed the small porch on her house (just re-built 9 months ago). It also damaged some siding and an outdoor light. There may be roof damage (there are still branches on the roof). There is also the huge tree to clean up. The old porch has to be removed (it's squashed). And it looks like the footers were knocked out of wack. And the door was damaged.

She called the insurance company. Even thought there was a ladder there the guy did not go on the roof (he said he couldn't lift the ladder). He said he would write up the damages and get in touch with her. Well, she received a check for $950 today. We told her not to cash the check, but I don't really know the next step.

She is getting another estimate. But how do we proceed? I've never made a claim for damages, only theft. There is no way she can get the work done for $950. Plus we don't even know if there is roof damage. Thanks.

Comments (34)

  • liketolearn
    16 years ago

    I've never had to file a claim but I think there are some basic things you can do:
    ~ As you said, do not sign or deposit the check.
    ~ Take lots of pictures ... close-up, far-away, from the ground, from the ladder ... detailing each problem and showing what caused the damage. The more pictures you have the better.
    ~ Get 2-3 contractors in to put together a detailed estimate of repairs that are needed. Be sure to give them a list of the things that you know needs to be fixed and a list of things that you think might be problems (foundation cracked or moved, etc). You want to be sure that everything is included on the bid.
    ~ Check your policy to see what the deductible is (it may be higher than your MIL remembers).
    ~ Contact your agent to let them know that the amount of the check does not cover the damage and you are submitting copies of estimates to cover the repair. Be sure to keep originals of everything and only submit copies (insurance companies are notorious for loosing paperwork). Get your agent to work with you to get a fair settlement from the insurance company.

  • triciae
    16 years ago

    Check your MIL's homeowners policy. There may be a cap on reimbursement for tree damage. Don't forget the deductible. The insurance should pay for the porch/roof, etc. but possibly not the clean-up of the tree. Or, a cap such as $1K is typical for tree clean-up (and some policies have a requirement that the tree must be at least "X" feet from the house or they won't pay anything).

    So, while you're waiting for a return phone call from the insurance company...read the policy.

    Good Luck & sorry to hear about the damage. Glad no personal injuries though!

    Tricia

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  • sue36
    Original Author
    16 years ago

    She has a $250 deductible. The tree wasn't on her property, it was on a neighbor's. It was a HUGE pine tree. It wasn't rotten, so no liability on the part of the neighbor. Even if they capped tree clean-up at $1k, they are trying to say it will cost $1200 (950+250) to remove the debris (including the porch), rebuild the porch, repair the roof and siding, and replace the door.

    She doesn't have an agent. The insurance is Hartford.

  • talley_sue_nyc
    16 years ago

    There's SOME sort of regional representative for Hartford who would fall into the "her agent" category.

    Biggest thing is, make the case. Get the proof--don't rely on the insurance company to do so; they have every motivation to low-ball your MIL. Get bids, put together a list of all that needs to be done, get pictures ASAP.

  • theroselvr
    16 years ago

    When my son had an accident a few years ago, I was sent a check even though I told them I was not filing a claim. I was told I had to cash it and send the money back to them with a letter saying I wasn't filing the claim.

    You really need to call an agent to see what needs to be done.

  • triciae
    16 years ago

    I agree. Get out the phone book & call the nearest Hartford agency. You may have to make a couple calls to find somebody who writes for Hartford. Then, explain the saga & they'll tell you what the next step is. Do NOT CASH THE CHECK. That includes depositing it in a checking account! (Sorry, but I've had people tell me, "I didn't CASH it. I put it in my checking account!" Duh?)

    Good Luck. From personal experience, I don't have much good to say about Hartford; but I don't have much good to say about any of them. We had our HO with Hartford about fifteen years ago. Our hot water heater broke & flooded the basement while we were out of town for a weekend. The claim was less than $2K. They paid the claim & then promptly cancelled us. :(

    Good Luck

    Tricia

  • chisue
    16 years ago

    Don't forget the "little stuff" that adds up like painting and gutters, etc. If there is roof damage, can you match the shingles? Need to replace a whole section?

  • sue36
    Original Author
    16 years ago

    Thanks everyone. I need to stop by her house this weekend and get all the documentation. We have a contractor going today to give an estimate. Not too many are interested in the job, it's too small. My BIL took pictures right after the storm, so we have those. The door was 6 months old and they depreciated it 15%.

    The letter from the adjustor said that if the carpenter couldn't do it for the $950 then to have him call them and they would "work it out" with him. Yeah, right.

  • minibim
    16 years ago

    I'm afraid you answered the problem and why the low dollar amount. You are now in an insurance loophole.

    It's your neighbor's tree. Your neighbor is liable for damages caused by his property and the tree is his property. His insurance company will argue "act of God". You still are going to have to somehow go after his insurance or pursue a civil lawsuit.

    Take lots of pictures before you do anything. Then she might as well work on clean up and repair and save all receipts, because she'll probably be awhile before anything can be resolved.

  • abbey_cny
    16 years ago

    I have to disagree with minibim's thoughts that since it is your neighbor's tree it is their responsibility. At least according to my insurance company (Traveler's) if a neighbor's tree falls on my property, and it falls on "covered property: i.e. house, car, etc. then I would have to go to my insurance company. It may be my neighbor's tree, but if it falls on my property then it is my responsibility. I learned this the hard way.

    Abbey

  • sue36
    Original Author
    16 years ago

    It is well established law in this state that the person who received the damage from the tree is responsible for the cost of the damages unless the tree was clearly rotten or something similar. This was a healthy pine tree. Who knows why it came down. No one was there, it could have been struck by lightening. It was a horrendous storm.

    The insurance company isn't balking about the tree, they are just low-balling everything. My MIL is sweet and highly non-confrontational. She didn't tell us the insurance guy was going to be there. If we knew DH would have gone. My MIL is the type to say "whatever you think is fair".

    So now it becomes my mess to deal with. She still has pieces of the tree on top of her house. Someone is going to remove it today. The tree came down sometime in April. She originally wanted the neighbor to pay, but we finally convinced her that it wasn't his problem.

  • spanky67
    16 years ago

    A couple of quick thoughts, especially given that I don't represent Hartford, and different states always mean different rules.

    First, the tree is your problem. The fact that it originated on your neighbors property means nothing. My policies cap removal at $500 as long as it hits something and not just the ground (you obviously can claim it hit something.

    Second, I think I now why the check is so small. I don't think your MIL has a replacement coverage policy. I say that based on your 15% depreciation comment on the door. If her policy is ACV then they will depreciate every aspect of the damage. That could add up to a significant amount.

    Third, how much of the damage was visible when the adjuster was there? Also was he a Hartford adjuster or a subcontractor hired by Hartford? If the tree was still covering much of the damage, he may be anticipating a supplemental claim. Basically they give you a check for what they can see, then follow up with more checks as more damage becomes visible.

    My first move if I was you would be to call either the adjuster or the in house file handler for Hartford. I would...very nicely...ask for an explanation of what the check was for. If you get the impression that Hartford thinks thats all they're going to pay, then ask for an itemization of what they think they're paying for. With that info. you can now go back and point out things they may have missed.

    I realize the hostility that always exists between claimant and claim adjuster...they realize it much more than you. They will be expecting hostility, but believe it or not they actually are human beings. If you start off nicely, you will get much farther. Most times these adjusters are being held to standards by managers...eventhough they may think you deserve more. If you can win them over, you may actually wind up with an advocate for your position. My guess is your mil wound up with Hartford thru AARP and as such has no agent. Beleive it or not, this is where we actually earn our keep.

  • sue36
    Original Author
    16 years ago

    She doesn't know if she has a replacement rider on her policy (it was one of the first things I asked). I need to see the policy this weekend to figure that out.

    Even if they can depreciate it, how much can they depreciate something that is less than a year old? The porch was ripped off and re-done last year. The door is new as well. Some of the old porch was able to be re-used, and you can see the color difference in the wood. How long are these things depreciated over? I mean, a porch can last 100 years, easy (assuming no falling trees!). A door is good for at least 20, I would think.

    All the damage was visible when he was there, he just didn't look very hard. Didn't go on the roof, didn't check the footers, didn't notice the light was wacked (it is crooked, not sure if it works or not). Didn't notice the gouges and missing siding. Really, the guy needs glasses. The porch was totally destroyed. Every single floor joist was broken in half. Not a single board on it was unbroken. Flattened.

    I don't know if the adjustor was with Hartford or independent. I do think my FIL signed up through AARP (years ago, he's since passed).

    I'll start of nice. I'm just aggravated that I even have to deal with this. Plus, she is basically a little old lady who has never made a claim in 50+ years (no exaggeration), and I feel like they are lowballing her.

  • berniek
    16 years ago

    Although I carry The Hartford/AARP insurance myself, their ranking used to be #1 in the left collumn, I see they've moved to #3.

    Here is a link that might be useful: FBIC Ranking 100

  • minibim
    16 years ago

    The laws may vary by state but the neighbor is liable since it is his tree. No different than an auto accident. If the other person is at fault, you make your claim for damages on their insurance.

  • Carol_from_ny
    16 years ago

    Since she just had the porch redone 9 months ago she must have some idea of what that cost. I'd get out those bills and start there.
    You need to talk to the agent and ask for an explaintion. If he can't give you a decent explaination then go to his superiors till you get the answers you seek. 950 sound awful low.

  • ultraviolet
    16 years ago

    minibim: I know of no state off of the top of my head that the neighbour would be liable for their tree damaging a neighbours property.

    This site as well as this one explain it.

    For the OTHER property owner to be liable, the tree would have had to have been OBVIOUSLY damaged/diseased pre-storm.

  • mfbenson
    16 years ago

    I'd ask for an itemized estimate that shows what was covered, and then provide documentation (pictures) of everything the adjuster missed.

    At the very least hartford should be able to provide a detailed accounting of how they arrived at $950. If they can't even do that much, contact the state insurance commissioner's office, and/or an attorney.

  • bethesdamadman
    16 years ago

    berniek: "Although I carry The Hartford/AARP insurance myself, their ranking used to be #1 in the left collumn, I see they've moved to #3."

    When I first read your comment, I thought you were saying that Hartford had dropped from the best to the third best insurance company to deal with. It wasn't until I clicked on the link that I learned that you were actually indicating that they had dropped (improved?) from the worst to the third worst! Wow! And it gets worse. Here's a footnote to the ranking:

    Hartford: The Hartford Consistently Gets The Hall Of Shame #1, 2 or 3 Worst U.S. Bad Faith Insurer With The Worst Complaint Record By Far!* The #1 Worst Record Of Claim Denials, Bad Faith Insurance Claim Practices And Non-Payment Of Claims. Very High Number Of Consumer Bad Faith Related Complaints And Lawsuits With Horrible Consumer Stories Of Foul Play And Claimants Being Victimized By This Insurer.* Large Insurer Group That Is Approximately One-Half To One-Third The Size Of Allstate and 15%-20% The Size Of State Farm But With A Multiple Many Times More Complaints, Coverage Denials And Non-Payment Of Claims In Comparison. Some Policyholders With The Company For A Number Of Years, That Were Surprised Initially To Hear Of Hartford's Very Bad Record Of Bad Faith And Non-Payment Of Claims Especially Those Never Having Or Making A Claim.* Don't Think Or Be Like So Many We Here From That Indicate To Us "I Didn't Think It Would Happen To Me". If You Insure With Hartford, Know That You Are At Very High And Greatest Risk Of Being Denied Payment Of A Claim.* Don't Wait For It To Happen To You ... If You Are Insured By Hartford, Be Advised That You Should Immediately Cancel Your Insurance And Switch To Another Insurer Before You Find Yourself (Like The Many Others) Being Denied Payment Of A Claim For Which You Paid Premiums Resulting In You Or Your Family Losing Everything. You Absolutely Do Not Want To Be Insured By Hartford ... Join With Others In FBIC America's Consumer "Buy Good Boycott Bad" Faith Insurers Of This Extreme Worst Bad Faith Insurer! (Member Companies Of Hartford Group Include: First State Insurance, Hart Life Insurance, Hartford Accident & Indemnity Insurance, Hartford Casualty Insurance, Hartford Fire Insurance, Hartford Insurance Of Illinois, Hartford Insurance Of The Midwest, Hartford Insurance Of The Southeast, Hartford International Life Reassurance, Hartford Life & Accident Insurance, Hartford Life & Annuity Insurance, Hartford Life Insurance, Hartford Lloyds Insurance, Hartford Underwriters Insurance, New England Insurance, New England Rein Corp, Nutmeg Insurance, Nutmeg Life Insurance, Omni Indemnity, Omni Insurance, Pacific Insurance Ltd., Property & Casualty Insurance Of Hartford, Sentinel Insurance Ltd., Servus Life Insurance, Trumbull Insurance, Twin City Fire Insurance).

  • spanky67
    16 years ago

    Minibim, will you please stop with the "neighbor is responsible" nonsense. In order for the liability to be considered, the neighbor in question would have somehow had to contribute to the loss. Owning the tree doesn't count. I deal with this exact situation several times a year...its not the neighbors problem.

    Sue, your point is valid about the depreciation. I never realized Hartfords reputation was sooo bad, but given what you're going thru, there may be some merritt. If you can dig out the declarations page it should state ACV or replacement right next to the dwelling amount. If you don't immediately see it, it may show some kind of code number which you then have to dig into the policy to decipher. There's usually a page with all the codes and what they mean. If you've got her policy number, you should be able to call Hartford and get that info. also.

    Getting the itemization is a critical first step. I think it will fill in many blanks. It may also not be a bad idea at this point to call her state insurance commissioner and start asking questions. They may give you some topics to hit on with the adjuster when you question the amount.

    As I've said several times, house insurance has rapidly become a big money drain on P&C company profits. That shouldn't matter to the average consumer, but it directly impacts how claims are handled. Personally, I also think some adjusters know that for every knowledgable claimant there are 10 lemmings. I know that shouldn't be the case, but kicking and screaming about it will get you nowhere. A knowledgeable client is usually the insurance companies kryptonite.

  • sue36
    Original Author
    16 years ago

    Thanks. DH and I are going to her house this weekend to get all the documents. I'll have to dig into this further next week.

    The porch was paid for by her other son, so she doesn't know what it cost and probably won't ask (they are weird about money in this family). DH doesn't really speak to his brother, so I'm not getting in the middle of that one.

    I contractor, who I know well, if putting together an estimate now. He already laughed at the $950 estimate.

    Here's a question. Several strips of cedar siding will need to be replaced. The house is is rough cedar, with a one of those oiled finishes (little color). It won't be possible to match the new siding to the old. Would insurance cover staining the entire side of the house? The entire house? Same thing with roof shingles. If some are missing or damaged, when do you get a new roof vs. just a patch job?

  • chisue
    16 years ago

    Ah, Sue, lucky you! I can see the headline now: Falling Tree Reunites Feuding Brothers -- Mom Rejoices! (DIL caught rolling eyes.)

  • jellyben
    16 years ago

    minibum, as someone on the receiving end of a neighbor's tree, I can tell you that the neighbor is NOT responsible for damage caused to someone else's property by his tree.

  • spanky67
    16 years ago

    I think your siding questions depends on several things. Most important, the answer to the replacement vs ACV question. Also, how much of a variation in color there is. If it's close, they probably won't replace it all. If it's an obvious difference you could try and argue that they should replace the whole side. You said the porch work was done fairly recently. Was all the siding replaced at that point or did they patch it in? If they see signs of patching in, then I can't see them replacing everything.

    The premise that I've always worked with when my clients have claims is that the company is responsible to restore you to the way you were before you had the loss. Given that, I would probably prioritize the importance of each repair. Or as my wise mom use to say "your not gonna' win 'em all. Fight the battles worth fighting". It seems like your in for a fight. You'll probably get the most by not trying to get it all.

  • cordovamom
    16 years ago

    minibim-- several years ago a neighbor of mine was the recipient of damage from one of my trees that fell and damaged his home due to an ice storm. The only way my insurance would have handled the situation was if my tree was diseased and that was the cause of the tree damage to his property. Since an ice storm felled my tree causing him in excess of $3000 in damage to his home, his insurance policy covered the damage to his home. I also must add that his policy only included $1000 in tree clean up fees.

  • mnk716
    16 years ago

    i am an adjuster for a major ins co. you CAN cash the check. there is no finality with 1st party coverage (unless you hit the policy limits). if there needs to be a supplemental check it will be made. an ins co cannot make you release your rights under the policy in lieu of payment. HO does not work this way. This is only used in 3rd party or liability claims which doesnt apply here.

    you need to call Hartford for a copy of the estimate break down and then advsie them it is not enough. 99% of the time they will come back and look at the property or work with your contractor.

    it is easy to assume the ins does not want to pay, this is not so. you paid your preimums and you are entitled to the coverage.

    most policies have a limit on tree removal but it should not affect your repair of the home. most tree companies charge $100-$250 to remove and chip up a tree.

    fyi: liabilty HO claims are subject to ACV and not replacement cost, but i do not think this is the case here.

  • sue36
    Original Author
    16 years ago

    I got all the documentation from MIL. I don't know who this adjustor is, but he clearly has less homebuilding experience than me. He totally missed the ballusters, handrails, misidentified the species of wood. The roof is damaged. There are chunks of siding missing and he didn't account for that.

    She does have replacement coverage, so I don't get the depreciation thing. I need to call them, but I need the contractor to add more detail to his written estimate as well.

    Tree removal is way more than $250 around here. You won't even get someone to come to your house for that. Plus there is nowhere to take them. The nearest disposal for trees is an hour away, so there is 2 hours of labor plus the dump fee there. It's a pine, so no one wants it. This was a huge tree, over 24" diamter.

    I don't know how to handle the siding and roof issue. The siding can probably be matched good enough, especially if we powerwash and restain the entire side (can I ask for that? It's cheaper than replacing the siding on the entire side). There is no way to match the roof, but the roof is circa 1990, and it isn't visible from the ground. Do we just patch that section and have it not match? I don't want to over reach, but I also don't want to not ask for what she is entitled to.

  • mnk716
    16 years ago

    If there is a dispute as to addl items just call the adjuster and he/she will come back to review.

    however if the damage is not immediate to the area there may be a dispute as to whether it is related. work with the adjuster.

    most HO companies pay the depreciation first then once you submit evidence of work completition they will send you the difference (minus the deductible). i dont know the exact % of roof damage before they would ok to pay a replacement but it will have to be large, same thing with siding, unless it was a rare color. i would ask hartford if they can recommend a tree company. if there isnt any then unfortunately you will just be paid the max for tree removal.

  • sue36
    Original Author
    16 years ago

    Well, there is nothing to come back to review. The work has already been done. Dump trips made, etc. The guy took pictures, I guess he could reference those. This is her only door into the house on the first level (other than through the garage, and that is difficult for her), so we couldn't wait to start work.

    The siding would be impossible to match. It's natural rough cedar clapboards, not painted. Roof would be impossible to match as well.

  • spanky67
    16 years ago

    Boy, you just made your life more difficult. Unless those pictures are real clear and specific I think you might be wasting time on the roof and siding. I would still go at them with everything you think they missed, but be prepared to negotiate backward. If the work was already done, what did you do with the siding and the roof? It's going to be a little difficult to ask them to pay for an entire replacement if you just patched it in.

    Regarding the other stuff, absolutely go after them. You are not being unreasonable in expecting them to pay for railings and ballusters. Get your paperwork in order and go back at them.

  • mnk716
    16 years ago

    you should have consulted with Hartford first. if there is an emergency (leaks, no doors, etc.), thats ok but Hartford has the right to review all damages prior to starting work.

    if you patched the roof and siding i dont see how you should be paid for a new roof and siding.

  • sue36
    Original Author
    16 years ago

    The roof and the siding haven't been done, only the porch has been started. It is the only access into the house, she can't wait any longer.

    Honestly, Hartford should have gone into the roof! The ladder was right there. Do we actually have to prop it up for the guy? Really, how could there NOT be roof damage when huge branches were still on the roof when he was there?

    Hartford had a right to review all work, they were THERE, they chose to send an incompetent.

  • mnk716
    16 years ago

    an adjuster will normally not use a homeowners ladder for liabilty reasons. they should have their own.

    either way you have to call Hartford and request a reinspection of the damages unless they are willing to work with the contractor directly

    what is the actual damage to the roof?. roofs are pretty strong and are meant to take a pounding from wind and objects.

  • sue36
    Original Author
    16 years ago

    Several shingle are missing from the the roof. I called the adjustor and left a message. The tree was only about 30' behind the house (neighbor's property) and it side-swiped the roof and siding as it hit the porch.

    He didn't bring his own ladder and said he couldn't lift the one that was there (DH has no trouble lifting it, it's his ladder).