State Farm Under paying claims

:shock: Unreal how insurance companies can get away with underpaying! And listening to the same false regurgitated lines is sickening. Mike Michalec (Work210-382-9115) with State Farm has delayed and denied to the point of no contact. Mike states “he and State Farm do not have to follow codes.” This statement came even after we went to Code Compliance and sat in the same room listening to Ramiro Carrillo (210-288-3236) Senior Building Inspector state that codes are to be followed. We wrote to Ed Rust Jr CEO of SF a letter (State Farm Insurance Company One State Farm Plaza Bloomington, IL 61710-0001 (309) 766-2311) and he assigned a Brad Clear (214-383-6384) to respond. Brad stated he just wanted me to know they received my letter. Brad Clear never stated to us, but apparently he assigned the 5 cases to Adrian Cooksey (210-414-4760) whom told my clients she had been trying to get with me with no luck. Like I told my clients, have you had a problem, they answered no, so I said someone is fibbing and it sure is not me…? Adrian said she was going to pay and then yesterday before our meeting at 2:30PM she had canceled at 10:27PM stating her Mike and their attorney are getting together again before our meeting and she had no clue when she would get back with me.

No we won’t pay, oh I guess there is damage, we will pay something, oh here is a little more now go away, okay we will pay correctly, wait nope we won’t, test us! We are a multi-billion dollar company in a trillion dollar industry for a reason, that reason is stealing insured’s monies…

Is it because it is profitable to deny and leave insured’s vulnerable? Insurance Company answer…Yes :stuck_out_tongue:

I’m not sure how the insurance laws are in Texas. Texas seems to have a much better State Department of Insurance than most states that is very involved in regulating what the insurance can, and can’t, do.

It is my understanding that in most states, the Insurance company is not liable to pay additional charges to bring a repair up to present code. Policy Holders have an option of paying a little extra on their premium to include this service. If the Homeowner doesn’t pay for this, it is their responsibility to pay the difference between what it costs to restore the damage to like new condition prior to the damage and what it would cost to restore it plus bring it up to code. A good example would be a cricket for a chimney more than 32" wide. I believe this became code in 2008 with the IRC. I can only assume if TX Dept of Insurance requires that insurance pays for damages and bringing property up to code, all TX Homeowners are automatically charged that premium service.

What does the Homeowner’s policy state regarding this?

The policy states they owe for it.

I have provided the information in writing to them, however, my request for their denial in writing comes in the form of “we don’t owe for it”. Again WHY NOT? No response. Wouldn’t it be professional and proper to at least reply in writing why not? :?

I believe they are testing as they have in the past, trying to break the small business company and most, once the insurance company pushes, most back off, so they profit illegally and I think they expect that to happen here.

Yes the TDI has many consumer protection laws in place for items such as this, however the lack of penalties against P&C companies is making me start to believe that all DOI’s are being bought and paid for; evident by documented cases. :frowning:

roofdoctor, that’s strange indeed. One thing is for sure, once the insurance company thinks you may be getting an attorney involved, they clam up like none other. Must be part of their Adjuster Training 101.

I have actually spoken to agents who didn’t have a clue what Ordinance or Law coverage was.

Don’t be shocked when they file some sort of action that you are acting as a public adjuster. Your contract is with the homeowner and not State Farm.

It doesn’t matter what you have signed because every standard homeowner or commercial policy out on the market states clearly that a policyholder cannot assign or transfer its rights to any other party.

The other issue that comes into play is that technically and legally, they cannot discuss or disclose any information that is deemed to be private. Many of the state and federal privacy laws prevent them from even discussing with you a financial transaction of someone’s claim.

Most insurance companies and adjusters do it out of courtesy and service. Legally, the insurance carrier can get in deep water. All it takes is one relationship to go South between a homeowner and contractor. Then, the contractor pursues some action against the homeowner and starts seeking $$$.

The homeowner finds out that the contractor has a copy of the insurance estimate and then drags the insurer in and claims that their privacy was violated and they win that battle every day of the week. Hell, some states will deem if an insurer names a company on a check that they are defacto authorizing repairs and then required to guarantee the work.

I work as an IA now and have worked staff for a couple of the larger carriers prior. There is no one rule of thumb or anything that is 100% consistent between insurance companies. They all have the quirks and hot buttons. I’d be careful if SF has their legal team involved.

What the policy states and what is covered is 2 totally different items. OL is an endorsement that cost extra. Not every homeowner buys it.

I am just wondering, what is your intention in naming people with their phone numbers? Are you trying to embarrass them in a public forum?

If I was the adjuster I wouldn’t tell you anything. Period. Of course this is my 2 cents.

Well I’ve done quite a few of State Farms insurance work and have always been happy with the claim amounts but they are tight with their numbers. It al depends on when th workcoms in from an area thats been hit bc the money gets tied up after they start paying out alot of money and thy get very tight aftern a while.


State Farm does not pay for drip edge and they do not pay for cap shingles. Cap shingles and drip edge our both required by the manufacturer of the shingles and most building codes. Someday there will be a class action law suit against them. For now they are simply a huge corporation that has bean counters watching the bottom dollar trying to make a profit by raising premium, raising deductibles, and not properly paying out on legit claims. It has happened before and it will happen again. They have had issues before with not paying properly and getting sued on a lagre level. The courts and judges are pro insurance and you must have a huge claim to sue to make it worth while. They are too stupid to realize that history repeats itself. Espicially when they are cheating on every roof claim. Just have your customers be ready to join in the class action suit pops up.

They will typically pay for cap shingles when the roof being replaced is 30 year dimensional. They bundle cap into waste when a 20 or 25 year 3 tab is being replaced.

I’ve rarely had problems getting paid for drip edge.

They say that every time to scare ignorant contractors off. SF has paid for these in the past with the same policy. They are arrogant at best, so I believe they do not really talk to their legal department because don’t you know, they know it all. “You are the only contractor asking for (name it), why would we pay if nobody else is asking for it?” If they are getting with legal, then legal is telling them to delay because the hard facts are the hard facts, they owe for it and they have paid for it in the past on other claims.

USAA Insurance Blake Ricks tried that and the TDI deemed we were well within our rights.

The insured is the Boss, they (we) pay the premiums, they choose whom who talks to whom and with who and when.

What the policy states and what is covered is 2 totally different items. OL is an endorsement that cost extra. Not every homeowner buys it.

I am just wondering, what is your intention in naming people with their phone numbers? Are you trying to embarrass them in a public forum?

If I was the adjuster I wouldn’t tell you anything. Period. Of course this is my 2 cents.[/quote]

Everybody is entitled to their 2cents, that is the beauty of America, but if your Boss tells you to speak with whomever they instruct you to, you do. The Boss is the premium policy payer and the adjusters seem to forget who pays their bills.