Meeting with and insurance adjuster can be a very scary thing for a couple of reasons. The insurance companies are in the business of making a profit, not paying claims. They get to keep what money is left after claims to pay their bills and executives.
Another issue, particularly after a catastrophic event like hurricanes, earthquakes and fires is because there are not enough local adjusters to handle all of the clams in the affected area. To deal with that lack of local staffing, adjusters are brought in from across the nation. Often they are uncomfortable because there are not enough hotel rooms, they are overworked, poorly fed and yes, do not have local ties to your community. They will never need to face an insured person they decline or treat unfairly EVER again. And, oh yeh, ….the supervisor that looks at the payouts from the company will be doing their next annual review
I have known many adjusters and companies that will give their insured every last penny that they are owed, and sometimes a little extra just because they are good companies and great professionals who will always do what is right. However, as of this writing, there are reportedly some unpaid legitimate claims from Hurricane Sandy, a hurricane that happened on the east coast years ago.
Bottom line, some companies are very fair, some not so much. In any instance, the adjuster has your life in their hands.
If you can get a copy of your policy, READ IT BEFORE MEETING WITH THE ADJUSTER
Take the information that you find in the policy and categorize your loss by the type of event that caused the damage. If that sounds complicated, let me explain.
For almost every insurance policy, you need “Flood Coverage” to cover flood damage. If you do not have that rider, all may not be lost if you understand the areas where you do have coverage.
Wind damage is often covered. As an example, if the roof blows off, that part of the loss may be covered even though you did have some flooding.
Water damage from leaks other than flooding is covered. Let’s say you have some flooding in a basement or lower level. You also had shingles blow off of your roof and water damage in the upper level. That damage may be covered.
In summary, read your policy and know how each portion of your damage occurred.
If you are not treated fairly, there are several paths you can take. Most policies allow for grievances to be filed for review. Another option is engaging a “Public Adjuster” these are professional adjusters who work on behalf of the homeowner that hires them. They review the loss and the policy and advocate for what the policy should provide the insured client.
Another issue, particularly after a catastrophic event like hurricanes, earthquakes and fires is because there are not enough local adjusters to handle all of the clams in the affected area. To deal with that lack of local staffing, adjusters are brought in from across the nation. Often they are uncomfortable because there are not enough hotel rooms, they are overworked, poorly fed and yes, do not have local ties to your community. They will never need to face an insured person they decline or treat unfairly EVER again. And, oh yeh, ….the supervisor that looks at the payouts from the company will be doing their next annual review.
. Do I have Insurance Coverage?
The answer to that question is "that depends." The first thing you should do is read your individual policy. Some insurance companies offer fairly good coverage for mold. Many other insurance companies have limits or exclusions for mold.
The key to obtaining mold coverage is understanding that there are policies that cover mold consequential to a covered loss. In English, that means if something like a pipe breaks and you get mold, it could be covered. If the mold is because your basement walls leak when it rains, it's probably not covered.
Flood damage is generally not covered unless you have "Flood Insurance. " You may find it interesting that according to a piece of literature just received from Travelers Insurance, 25% of flood claims occur outside of flood areas.
CLUE Report can Solve Your New Home's Mysteries
You are looking at what may be your dream home. The house looks great, but it also looks like there may have been a roof leak, or maybe a tree fell against the house or sewer backup. Maybe you did not notice any of these potential indicators of previous problems, and the seller may have "forgotten" to mention the previous home tragedies .
Imagine your surprise to find out that the home you just purchased had a fire, mold problems, or a flood from broken pipes. If you do not think that happens, I can tell you first hand that it does. As an inspector, I hate the panicked look on a client's face when I ask questions like: "Did you know there was a fire in this home?"
Unveiling the Disaster Response Cover up
There is one disaster response franchise that uses the advertising tag line "Like it never happened". The point they are trying to make us is that the evidence of the disaster or tragic event will not be visible. However, if "it" really did happen, it could affect the insurability of the home and be an indicator of "covered up" defects. A $10,000 mold cleanup that did not address the cause of a mold problem could become your $10,000 problem next year. Broken pipes from freezing can be avoided if you know what conditions cause the broken pipes. Knowledge is power to avoid previous problems learned from experience.
A little detective work can save you a lot of headaches when you purchase your next home. To help you do that due diligence, let me introduce you to the CLUE report . CLUE stands of Comprehensive Loss Underwriting Exchange.
We have all heard of CARFAX. This service tells you all the dirty little secrets of the previous owners of the used car you are about to purchase. What most of us have never heard of is this very similar service for homeowners and home buyers.
The Potential Land Mine News About Your CLUE Report
The insurance companies argue that the benefit to consumers is that the service helps to keep premiums lower for good customers by avoiding higher risks. Repeated claims on a home can be indicative of a building with many problems or an insured that commits fraud or makes bad claims. This is sometimes true. There can be a solid argument for this "risk avoidance" by the insurance companies. This is not a "good thing" when your "new to you" home is the one being kicked to the insurance policy curb because of the previous owner.
CLUE reports can be a nightmare for a new and unsuspecting buyer purchasing a property. Most states allow insurance companies 60 days after issuing a policy to review adverse information about a home. You could lose your homeowner's insurance 30 to 60 days after you purchase a home because of what was on the previous owners' CLUE report. Most lenders require that homeowners insurance remain in force, or they can foreclose on the home.
CLUE Reports are administered by CHOICEPOINT, which is a data management company. The reason to know about this company is that at the same time they manage the data relating to your home, they also manage your personal data as the homeowner. The data provided in CLUE reports includes policy information such as the homeowners name, date of birth, policy number and claim information such as date of loss, type of loss and amounts paid.
A-Plus (Automated Property Loss Underwriting System) is another company that provides the same service as CHOICEPOINT. The insurance Services Office, an insurance industry organization, runs A-Plus to which about 1,250 companies contribute. Most people refer to the reports generated by either system as CLUE reports and for simplicity, we will do the same here.
Requesting and Using a CLUE Report as a Home Buyer
Unfortunately, as a buyer is in the process of purchasing a home, you can't order a copy of the home's CLUE report. On the other hand, you can request that a seller obtain a copy of the report and provide it to you as the buyer. The seller can obtain a copy of their report through their insurance agent or at the website:
https://personalreports.lexisnexis.com/homesellers_disclosure_report/landing.jsp
Once the real estate has closed, the buyer is then the owner, and can obtain the CLUE report using the methods above. However, the new homeowner may find a "surprise" of previous claims too late to protect from buying a problem property.
Some realtors are now encouraging buyers to start shopping for homeowners insurance coverage early in the real estate transaction process. They can include a contingency that the purchaser must be satisfied with the insurability of the property for the transaction to proceed.
Keeping You Out of the CLUE Controversy
One of the most controversial issues surrounding the information found in the CLUE database is that an innocent inquiry from a homeowner to their insurance company concerning their deductible or a possible claim, can trigger a file to be opened in the CLUE database-even if the homeowner does not file a formal claim. Keep this in mind when discussing potential claims with agents and insurance adjusters.
When Buying or Selling a Home, Get A CLUE Report
When selling, get a CLUE report before listing to avoid an embarrassing disclosure problem. This kind of surprise can derail a house sale. The report is free, and the avoidance of problems is priceless. A buyer that needs a mortgage will not obtain that mortgage unless they can purchase homeowners insurance. As a seller, if a deal goes south before closing over insurance issues, it will be very difficult to find another buyer.
When buying a home, request a CLUE report from the seller at the same time you make an offer. If there was a serious problem, the information can help your home inspector investigate the homes condition.