Are insurance companies tightening up, there?

They are, here.

Two years ago, six hail hits a square on three faces constituted a roof replacement. Today, I see them require 8 and even 11 per face. I also had an adjuster turn down a roof replacement because the face behind the trees was not damaged enough (the other three were).

We had an F1 tornado here, and many newer roofs are almost completely unsealed at the tar strip, but not yet moving on the nails. They say that that is not wind damage :shock: How do you explain that to the homeowners?

The insurance policies only say that wind damage and hail damage are covered. The insurance company wrote the policy and did not exclude the roof.

I ask for reinspections a lot, but I worry that the insurance companies are black balling me. Well, no, I know that one is, for sure.

How are you all handling the insurance adjuster “dance”, there? I feel that we all need to be reasonable (and I am respectful and polite at all times), but it is hard to look a few years down the road to expect a “wear and tear” ruling, leaving the homeowner having to pay for this damage out of pocket.

This is purely speculation but it feels like Adjusters did tighten up the past month. My theory is that many insurance companies operate on a calendar year as their fiscal year and the budget for claims payouts ran dry. It does seem like, in the past year, that several insurance companies also tightened up on their standards for approving roof replacements along with cutting some $ out of what they would pay.

I would question that an insurance company would formally “blackball” a contractor by documenting anything internally. If this somehow ever came to a lawsuit, they would potentially be compelled by court order to produce those records. I do think a local field Adjuster can personally blackball a contractor or even make some comments about a given contractor to other field adjusters working out of the same office. I’ve heard field adjusters make disparaging comments about other contractors so it stands to reason they would make these same comments to their peers. Not very professional but it is simply human nature.

Authentic Dad;

Thanks for your insight. I guess it is comforting to hear that it might lighten up in a few days.

As to targeting me, I filed five claims (I file them for the customers), and the same adjuster :twisted: the polite and courteous contractor I was at first.

Usually, I get about ten days’ delay after I file a claim until the adjuster meeting. This guy was inspecting all my claims within 24 hours. He turned them all down, and they were all damaged.

I usually have a variety of adjusters from this insurance company, too, so I feel sure he has a thorn in his side.

No big deal, though, to me. I am sure it will blow over, or I will strategize how to stop this. Our state insurance code says we all have to be :expressionless: reasonable.

I think that is different with every company out there. I don’t think that you can lump all insurance companies into the same category. Some may be a little tighter while others have lightened up. In general I have not seen a consistent tightening up across the board. Some are strict and others are not, just the luck of the draw.

As far as companies paying based on the calendar or fiscal year, that does not seem to be the case at all. I have been an adjuster for going on 6 years and worked for 20+ insurance companies and nothing even close to that has ever played a role in my decision to pay or not pay for a roof. Good Luck with your adjuster.

Thanks, tj.

I will try to see a better relationship in 2010 regardless of why. I think your way is the right way. I agree that it is sort of a crap shoot.

With another company, I got 11 straight “yes” responses to homeowners’ claims, then I got three straight “no” answers.

I had an adjuster, who was one of the eleven, turn the homeowner down and say to me on the roof that the insurance company was reinspecting almost everything he had done. I have heard that several times recently.

I wonder if the insurance company knows who routinely turns down claims, too? I do. Might they turn to those adjusters if they overshoot their claims budget?

There is a huge variance between adjusters here.

Also, does there seem to be a variance between staff adjusters and independent adjusters? We conicidentally ended a storm catastrophe, and the claims now are routed to the staff, I think.

Did you ask the Homeowner to call their insurance company and request another inspection with a second set of eyes? Any time we have an inspection and feel strongly that the adjuster was incorrect in their judgement to deny the claim, we take this route. There is certainly a difference in adjusters, some certainly are more inclined to deny nearly everything while others seem to be more objective. With few exceptions, the insurance companies have agreed to these requests.

As to whether or not insurance companies vary with respect to the period of a fiscal year or not was purely speculative. However, we have had more than one adjuster tell us that they’ve been instructed by “Management” that the standards or guidelines for approving roof damage claims have been “modified”. These modifications have always been to a more stringent set of guidelines. I seriously doubt the field adjusters would be plainly told that the yearly claims budget has been used up so they have to start denying claims. It would be less incriminating to simply give them a different set of standards to utilize. I’ve seen this happen in the same calendar year for the same storm. Form your own conclusions.

Yes I think that staff adjusters are more strick than independent adjusters for many reasons. In general I would think that independent adjusters are more willing to lean on the side of the homeowner.

The reinspect can be another staff adjuster. Depends on the size of the area you’re working in and the size of the insurance company but the bigger ones will generally have multiple staff adjusters working out of an office.

When I know a roof has substantial hail damage and the homeowner agrees with me, it never hurts to have an attorney on your team.

Sometimes just a letter mentioning “bad faith claim” will do the trick. :wink:

Authentic Dad;

You hit on the heart of my questions. I wondered whether to reinspect with this company, now. I do not want animosity with the insurance company, and I want the homeowners treated fairly, too. That is the fine line we walk.

Does it seem logical to wait a while to see if things cool off with this insurer? That is the direction I’m leaning, right now.

TJ;

I wish all adjusters looked at their work like you do and just did what is reasonable. I know guidelines vary from insurer to insurer, and that makes it hard for us to call in damage that meets the insurers’ guidelines. I don’t want to waste anyone’s time and money.

jmreaves;

I don’t suppose you could pull out and post a sample “bad faith claim” letter, could you?

Also, could you elaborate on its use? I assume it is a letter from your company (via your attorney) to the insurance company.

Also, how many of you use the insurance company’s umpire process vs. the state insurance board, and how effective do you find both?

[quote=“Gary”]Authentic Dad;

You hit on the heart of my questions. I wondered whether to reinspect with this company, now. I do not want animosity with the insurance company, and I want the homeowners treated fairly, too. That is the fine line we walk.
[/quote]

Gary, I believe the Homeowner needs to be the one to contact the insurance company and request the reinspect. I don’t see how this causes animosity with the insurance company. I personally believe as you in always being respectful and professional in the interactions with the insurance company. But there is also a point where you have to stand firm in what you believe is the right thing to do. And if there were no emotional conflicts that occurred during the initial inspection, I see no reason for animosity to exist if a reinspect is called for. The insurance companies know the majority of the people told no do nothing further so persistence is often the best tool for success.