SENT VIA FIRST CLASS MAIL AND
CERTIFIED MAIL RRR#xxxxxxxxxxxxxx
xxxxxxxxx, TX xxxxxxxxxx
RE: xxxxxxx Claim #xxxxxxxx
xxxxxxx, TX xxxxxx
After our meeting last week and your blatant disregard for your policyholders rights, I felt the need to follow up with you with this letter.
During your initial adjustment, you failed to write an accurate estimate for the roof and the storage shed. You also failed to recognize obvious damage to patio cover, detached building and carport. I was contacted and contracted by Mr. xxxxxxx to assist him with the repairs to his home. Upon my inspection, I found damage to the roof on the dwelling, damage to the roof on the storage shed, damage to the patio cover, damage to the detached garage and damage to the carport. After my inspection, I prepared an estimate for the repairs to the xxxxxxxxx home with materials of like kind and quality for what was actually there and work that actually needs to take place. At Mr. xxxxxxxxx’s request, I then scheduled for our company to install temporary weatherproofing to the home and storage building to prevent further damage due to rainy weather that had been forecast for later in the week.
Upon receipt of my estimate, you and I scheduled a re-inspection of the property on Wednesday, October 28, 2011. Upon my arrival at the xxxxxxx home, you had already been at the home for some time speaking with Mr. xxxxxxx about various ways you would like to handle the claim.
Our first communication was about the temporary tarps that were already installed and invoiced. You stated that you were only going to pay $250.00 for work that has been completed and our invoice amount is $750.00. Three tarps were installed in an attempt to save the homeowner and insurance company money and mitigate further damage.
The xxxxxxxxxxxxxx Homeowners Policy requires the homeowners to protect their home from further damage. - Form A in Section 1 - Conditions paragraph 3. a. 3 (a) “Protect the property from further damage” (b) “make reasonable and necessary repairs to protect the property.” (c) “keep an accurate record of repair expenses.” We have made reasonable repairs to prevent further damage. Form A Section 1- Property Coverage, Extensions Of Coverage 3. Reasonable Repairs. “If a peril insured Against causes the loss, we will pay the reasonable cost to you incur for necessary repairs made solely to protect covered property from further damage.” During our meeting, you refused to pay what had been invoiced and what is reasonable and customary for the temporary repairs that have already been completed. I have checked with various contractors around the area and have found that our temporary weatherproofing line item price of $250.00 for each tarp is in line with what other contractors are charging and I would be glad to provide you with their contact information if needed.
After our brief discussion about the tarps, you then immediately stated that you would only be paying “$195.00” per square for the roofing and that the price you were paying included other line items such as starter, ridge, drip edge, valley metal, chimney flashing etc. and that you were not going to discuss the roof anymore, period. I was amazed by what I was hearing. You stood there in front of the homeowner and told us that’s all you were doing and if I didn’t like it that was just too bad. You also stated that you could have ten (10) other contractors do the job for what you were paying. I was amazed again by your actions. You, being licensed by the state of Texas are obligated to make a fair and equitable settlement to Mr. xxxxxxxxx, and all you were doing was acting like a bully on a playground. When I explained to you that those contractors did not know what they were doing, you then seemed dumbfounded. The policy makes provisions to repair or replace with materials of like kind and quality. Those other companies you mentioned are not repairing or replacing the components with materials of like kind and quality. If they do not know how to properly estimate their jobs, how can you expect them to do the work properly? I have prepared a fair estimate for all of the repairs that must take place on this home that are covered under the policy and that should be addressed.
I was appalled by what I found out next. You had taken Mr. xxxxxxxx to look at the carport. You “talked him into taking an appearance allowance” without giving him the facts. Mr. xxxxxxx is not a General Contractor, insurance adjuster, roofing contractor or even a public adjuster and does not have intimate knowledge about his policy or required repairs. The fair market value for the repairs to this carport are approximately $5,000.00. You had my estimate for the repairs in your hand and you were just looking for a way to not pay what was due. You failed to tell Mr. xxxxxxxx that if he took this “Appearance Allowance” that he would never be able to claim future damage, and be paid fully for his repairs. Had he known you were only telling part of the story, do you think your manipulation of the situation would have had a similar outcome? I don’t think so. You should reconsider your actions and estimate properly for the carport that was clearly damaged.
You scheduled a re-inspection for the property, yet you and I only looked at the patio cover together and barely discussed that. You were too busy saying, “I am not going to talk about the roof,” to do anything else. After doing a little research on the xxxxxxx’s policy, I find it very interesting that you would take a position such as you did.
First off, you stated that you were only going to pay $195.00 per square for the shingles, and that included additional items such as starter, ridge, drip edge, valley metal etc. According to the Smallwood’s policy, The xxxxxxxxx Homeowners Policy - Form A in Section 1 - Conditions 4. Loss Settlement. “Our limit of liability and payment for covered losses under section 1 property coverage will not exceed the smallest of the following. a. The actual cash value at the time of the loss determined with proper deduction for depreciation; b. The cost to repair or replace the damaged property with material of like kind and quality, with proper deduction for depreciation; or c. the specified limit of liability.” You have failed to do so in your estimate.
“Xactware is an independent, third-party company that researches and reports on industry pricing. We use pricing information from general contractors, subcontractors, insurance carriers, insurance adjusters, and a host of other industry professionals as we research and report on the average market price for each price-list item. Xactware goes to great lengths to ensure that no one party or industry segment has any undue influence on the pricing data that we research and report on.
Having the right pricing information is critical to creating an accurate estimate. That’s why Xactware currently researches and reports on industry pricing for more than 470 geographic regions in the U.S., Canada, United Kingdom, and Ireland via our estimation and valuation software. Each of our cost databases is fully researched, validated, and supported by Xactware’s in-house team of professionals, who have more than 400 years’ combined experience in the construction and restoration industries and have been providing building cost data to the insurance industry since 1989. As a result, Xactware’s published cost information has become the most widely used pricing data in the industry.
All of Xactware’s price lists are updated and published on an ongoing basis according to established publication schedules. For example, Xactware’s pricing data on structural repair and cleaning (including contents cleaning) is published monthly in North America.”
The reasons above are exactly why xxxxxxxxx has started using Xactimate and Xactware’s products. The current published pricing is widely recognized by many insurers and contractors alike, and we can easily verify any pricing with your colleagues in your office if you like.
“RE: What is included in the following line items.
xxxxxxx]; on behalf of; Pricing [email@example.com]
Thank you for your inquiry. Xactware’s published pricing for roofing items is not ‘all inclusive.’ For example, items for roofing shingles (RFG 220, RFG 300, etc.) include shingles, felt, nails. As they are originally published in Xactimate pricelists, they do not include any cost or assumptions for hip/ridge, drip edge, valley or other roof flashing, pipe jacks, roofing vents, steep/high charges, sales taxes, etc. If needed, these items should be added or accounted for separately in the estimate.
Structural Data Services
Having already established Xactimate and Xactware as an authority on pricing, you can clearly see in the above email I received directly from Xactware, that your statement was false and that all of the additional line items such as starter, ridge, drip edge, valley metal etc. are not included in their line item pricing for shingles, which by the way, at the time of our meeting were $195.17 per square not $195.00 per square for shingles felt and nails only. I am sure that was just an innocent mistake.
At one point in our conversation, you stated that you, “would not be allowing for waste on steep charges associated with the roof.” I asked you why. You said, “I am not going to discuss the roof anymore.” I again was blown away with your response and attitude toward a fair settlement. A colleague of mine received the following email from Xactware:
“From: xxxxxxxx] On Behalf Of Pricing
Sent: Thursday, February 10, 2011 5:12 PM
Subject: RE: RFG Steep, Steep>, Steep>> and High + Clarification Question
Thank you for your email. As stated in a previous email:
The add-on line items for steep charges, RFG STEEP*, are intended to match the respective quantities used for the respective removal and replacement activities of the roofing material; e.g. if 20 sq. is being removed and 23 sq. is being replaced, the steep charge would normally use the same respective quantities of 20 sq. for removal and 23 sq. for replacement.
Structural Data Services
In layman’s terms, the quantities for removal of the shingles should equal the quantities for the removal steep charges and likewise, the quantities for replace should equal the quantities for steep replace charges accounting for waste. After all, do the installers not have to carry and manipulate the materials that will become waste up on the steep roof?
This is what I found after doing a little research into the xxxxxxx’s policy.
“The xxxxxxxxxx Homeowners Policy - Form A in Section 1 – Property Coverage, Extensions Of Coverage 3. Reasonable repairs. If a Peril Insured Against causes the loss we will pay reasonable cost you incur for necessary repairs made solely to protect covered property from further damage.” “The Texas xxxxxxxx Homeowners Policy - Form A in Section 1 – Conditions 3. Duties After Loss a. Your Duties After Loss. In case of a loss to covered property caused by a Peril Insured against you must: (3)(a)protect the property from further damage. (b) make reasonable and necessary repairs to protect the property. (c) keep an accurate record of repair expenses.” The policy clearly states that the homeowner is required to protect the property from further damage and that the insurance company will pay the reasonable costs incurred for those temporary repairs. Why would you choose not to follow your policy provisions. The fees are reasonable according to the market, and the work is complete and has been invoiced. You should honor your contract and pay appropriately.
“The xxxxxxxxxxx Homeowners Policy - Form A in Section 1 – Property Coverage, Extensions Of Coverage. 1. Debris Removal. We will pay your expense of removal from the residence premises of: a. debris of covered property if a Peril Insured Against causes the loss.” The policy clearly states that you will pay for debris removal yet you attempt to manipulate the situation and state that it is included in “your” shingle prices. I have already established Xactware to be an authority on pricing in our market and proven that the pricing does not include removal of other line items. You need to review your “estimate” and account for removal of shingles, removal of 2 layers of drip edge, removal of valley metal, removal of pipe jacks, removal of chimney flashings, removal of turtle vent removal of ridge cap, removal of gutters and downspouts and that’s only on the dwelling. You will also need to account for removal of aluminum corrugated sheet roofing and removal of drip edge on the detached carport. You will also need to account for removal of aluminum corrugated sheet roofing and removal of gutters on the attached awning. You will also need to account for removal of 3 tab shingles, removal of drip edge, removal of ridge cap and removal of attic vent on the shed. This material must be hauled off after it is removed. I have accounted for removal of these items and the haul off of these items in my estimate. You will need to address these as well, in order to accurately address the repairs covered by the policy.
“The xxxxxxxxxx Homeowners Policy - Form A in Section 1 - Conditions 4. Loss Settlement. Our limit of liability and payment for covered losses under section 1 property coverage will not exceed the smallest of the following. a. The actual cash value at the time of the loss determined with proper deduction for depreciation; b. The cost to repair or replace the damaged property with material of like kind and quality, with proper deduction for depreciation; or c. the specified limit of liability.” Doesn’t that mean you are required by the contract to replace the roof with materials of like kind and quality? That being said, and having already established Xactware as an authority on pricing, you must account separately for each of the following line items: shingles, felt, drip edge, painting of the drip edge, starter shingle, valley metal, pipe jacks, painting of the pipe jacks, chimney flashing, box vent, paint of the turtle vent, ridge cap, etc. All need to be accounted for separately and appropriately in your estimate. Under this same policy provision, you must also allow to detach and reset solar power attic vents and satellite dish. The steep charges would also be considered under this portion of the policy.
“The xxxxxxxxx Homeowners Policy - Form A in Section 1 – Exclusions 3. Building Laws. Building Laws exclusion is modified to provide coverage only to the extent described under Perils Insured Against. (a) Coverage Provided. You may use up to $5,000.00 (at no additional premium) for the increased costs that you incur due to the enforcement of any ordinance or law, which requires or regulates (1) the construction, demolition or repair of that part of a covered building or other structure damaged by a Peril Insured Against. “
There are various codes that must be followed during the re-installation of this roof.
“R905.2.7 Underlayment application. For roof slopes from two units vertical in 12 units horizontal (17-percent slope), up to four units vertical in 12 units horizontal (33-percent slope), underlayment shall be two layers applied in the following manner. Apply a 19-inch (483 mm) strip of underlayment felt parallel to and starting at the eaves, fastened sufficiently to hold in place. Starting at the eave, apply 36-inch-wide (914mm) sheets of underlayment, overlapping successive sheets 19 inches (483 mm), and fastened sufficiently to hold in place. Distortions in the underlayment shall not interfere with the ability of the shingles to seal. For roof slopes of four units vertical in 12 units horizontal (33-percent slope) or greater, underlayment shall be one layer applied in the following manner. Underlayment shall be applied shingle fashion, parallel to and starting from the eave and lapped 2 inches (51mm), fastened sufficiently to hold in place. Distortions in the underlayment shall not interfere with the ability of the shingles to seal. End laps shall be offset by 6 feet (1829 mm).” Waste should be applied to the felt according to the code.
“R907.5 Reinstallation of materials. Existing slate, clay or cement tile shall be permitted for reinstallation, except that damaged, cracked or broken slate or tile shall not be reinstalled. Existing vent flashing, metal edgings, drain outlets, collars and metal counterflashings shall not be reinstalled where rusted, damaged or deteriorated. Aggregate surfacing materials shall not be reinstalled.” This portion of the code applies to the replacement of the drip edge, valley metal, pipe jacks, turtle or box vent and chimney flashing.
“R905.2.8.2 Valleys. Valley linings shall be installed in accordance with the manufacturer’s installation instructions before applying shingles. Valley linings of the following types shall be permitted: 1. For open valleys (valley lining exposed) lined with metal, the valley lining shall be at least 24 inches (610 mm) wide and of any of the corrosion-resistant metals in Table R905.2.8.2. 2. For open valleys, valley lining of two plies of mineral surfaced roll roofing, complying with ASTM D3909 or ASTMD6380 Class M, shall be permitted. The bottom layer shall be 18 inches (457 mm) and the top layer a minimum of 36 inches (914mm) wide. 3. For closed valleys (valley covered with shingles), valley lining of one ply of smooth roll roofing complying with ASTM D 6380 and at least 36 inches wide (914 mm) or valley lining as described in Item 1 or 2 above shall be permitted. Self-adhering polymer modified bitumen underlayment complying with ASTM D 1970 shall be permitted in lieu of the lining material.” This portion of the code states what must be installed in the valleys. The home currently has valley metal installed and code requires that it must be replaced.
In conclusion, it is obvious that you have more work to do. Your previous estimates failed to account for many of the items that must be accounted for according to Mr. xxxxxxx’s Homeowners insurance policy. I would like to assume that the recent storms have been overwhelming and that you just missed some of these items because of the current work load. However, your actions at the loss location were quite the opposite. Your actions could be considered unfair claim settlement practices. I am attaching an updated estimate along with this letter. Please review and update your estimate as well. The xxxxxxxx family has been a good customer of xxxxxxxxxx Insurance and expects to be treated fairly, as they should, according to the Consumers Bill of Rights and xxxxxxxxxx Mission Statement. “Our mission is to build and manage a financially strong, efficient and member-oriented operation that supports the objectives and membership growth goals of the Farm Bureau parent organization; and to assist xxxxxxx members to manage the financial risks of everyday life and successfully recover from any insured loss through the delivery of prompt, professional, and personal service based upon high ethical standards and fairness.”