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Insurance Claim - when and how to fight

2,341 Views | 12 Replies | Last: 2 mo ago by RoyVal
WorthAg95
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2:40p, 9/30/24
AG
Any advice is appreciated.

Our claim from Beryl...just finally got the estimate from insurance back last week.

The estimate is to fix a chunk of part of our house and tear down and rebuild the garage. Plenty of several different trades.

Our contractors estimate and insurance estimate is about $50k apart so we find ourselves in a situation where everyone is basically staring at each other. I don't know the ins and outs of this stuff so I find it very difficult to say much of anything. Contractor is basically telling me they expect you to hire some guy on craigslist.

What needs to happen to get movement on this? If we need to hire a public adjuster is now the time or should we give it more time?

Are there other avenues to pursue?

Very frustrating...so thanks for any feedback.
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fire09
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6:37a, 10/1/24
AG
Just went through this. We went the route of legal representation.

General information for you that was shared with me by an adjuster who was not related to the case.

Most of all claims will not leave the insured $0 out of pocket less deductible less depreciation. This is especially true with claims that exceed $25k, water damage, and structural damage.

The adjusters use a software (xactimate in my case) to input damage to generate a settlement offer. It is almost impossible to locate a contractor willing to complete work at the prevailing wages/rates that the software uses for larger projects, including the insurance company's 'preferred' vendors.

Contractors familiar with navigating the insurance company can use supplementals to close the gap, with their success largely depending on the insurance adjuster and their documentation. There is little incentive for a contractor to do this nightmare process. (For most projects, you get the check, or draws depending on the amount, and are responsible for paying the contractor).

A public adjuster typically will net you a marginally higher settlement claim, and are rarely disputed provided the estimate is accurate and aligns with the insurance company's original estimate closely.

Hiring an attorney will generally net you the highest recovery, although you will likely be waiting months to reach a settlement.

Here was my scenario (using round numbers) that goes over the repair only part of the loss:

I solicited 3 bids for in kind replacement of damages and chose the middle bid.
Repair Cost : $51k (other bids $44k and $55k)
Xactimate estimate and final offer from insurer: $26k
Public adjuster estimate: $38k
Private adjuster (hired by my attorney): $85k

The private adjuster was the only one to find the damage that my floor was completely and needed to be replaced, which accounted for an additional $27k.

The case is working it's way through a negotiated settlement but we should end up hopefully covering most of the damage. It will be a miracle if we end up zero out of pocket. Insurance is a scam and the adjuster is not your friend.
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MAS444
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7:22a, 10/1/24
AG
Did any of yall see the 60 minutes story this past Sunday on insurance companies adjusting storm claims. I'd recommend watching it. And hiring a lawyer.
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fire09
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In reply to MAS444 • 7:58a, 10/1/24
AG
Just watched this. Disgusting, and equally unsurprising after my experience. Thanks for sharing.
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schwack schwack
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12:51p, 10/1/24
AG
Came here to post the 60 Minute story - this was eye opening and truly disgusting.

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Furlock Bones
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In reply to schwack schwack • 8:13a, 10/2/24
AG
GDed there are thing about this country that just make you want to rage.
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Jason_Roofer
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9:31a, 10/2/24
Adjusters are not contractors and they simply don't know how to estimate a lot of things. They are also tied by line items. Sometimes I have to write in hard bid numbers because there isn't a matching line item. Every roof I do, I have to re-supplement for missing items. Every one. What did the adjuster say specifically when you sent in the contractor estimate?

I've had luck with itemizing in Xactimate or having my homeowner sign a retail bill price bid and sending that into insurance. Sometimes they will just approve that outright.

What did the carrier say when you sent in the full price estimate? Sorry you have to going this, it's not ideal.
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WorthAg95
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10:36a, 10/2/24
AG
I saw the 60 minutes piece. Pretty awful. This is a huge point of pain for a lot of people but the majority don't ever have to deal with a big claim so it doesn't make the political radar.

Thanks for the info fire...hope all goes well for you from here out. Do you regret hiring the Public Adjuster and not just going straight to an attorney or do you feel that was a necessary step?

When I sent in the contractors estimate he came back about a week later and is now sending out a 'building consultant,' so we'll see where that goes. It is a third party but still hired by them so I don't expect anything but maybe it'll be progress. They hired an engineer to come out who said the garage needs to be torn down and also that much of the drywall in the house that is now cracked was caused by the tree but they are denying that work. Sounds like we will have to hire our own engineer if anyone has a recommendation.

I have a hard time accounting for what they are paying in their quote but for instance they are shorting me gutters by almost half and we're talking like 25 feet total. If theyre that far off on something like that what else are they shorting. I think the labor may be one of the most egregious.



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fire09
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In reply to WorthAg95 • 5:37p, 10/3/24
AG
In hindsight, I should have gone straight to an attorney. Public adjusters use similar wage and material costs that the xactimate software uses, so unless there are big scope misses, they aren't going to do that much for you. You hit the nail on the head, the black box these programs pull material costs and labor rates from and that the insurance companies hide behind as "industry standard" are so fraudulent it amazes me they haven't been bankrupted via class action yet.
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fire09
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In reply to WorthAg95 • 5:41p, 10/3/24
AG
One more thing, many of these attorneys that do this type of claim work on contingency. Standard seems to be 25-35% of the negotiated settlement. As a part of that fee, they should send all the necessary technical expertise needed to build your case. I would recommend speaking with an attorney prior to hiring anyone yourself. There are people who do this work specifically to help in lawsuits like the one you may likely find yourself in. A good attorney will have the right people lined up to help build their case.
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Stan Crowch
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8:57p, 10/3/24
AG
I'm going through this right now and using an attorney I've been very happy with. Feel free to PM if anyone wants contact info.
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MRB10
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9:16p, 10/6/24
AG
How are attorneys fees calculated on these property damage claims?
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RoyVal
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In reply to MRB10 • 8:18a, 10/14/24
AG
MRB10 said:
How are attorneys fees calculated on these property damage claims?
they take a percentage of what they can get from the insurance (I'm going through this as we speak for my roof and it's between 35-40% after all fees). In my scenario, the insurance told me nothing was covered so it was well worth me getting an attorney. If somebody is getting a low settlement, you better break out the calculator and see if it's worth getting an attorney involved knowing they get a cut of the entire settlement.
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