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A Claims Story
To illustrate just
what is involved in the claims process and how
Property Adjusters Associates can make a difference
for you, we will examine one of our recent losses
which involved a Limits Loss or Total Loss.
Our office was called approximately one month
after the date of loss, primarily because the
insured thought the adjuster was rushing them into
settling their claim. They were having a
difficult time preparing their contents inventory
and just didn't have the time.
The insured had a
1200sf 2 story home with a 12 x 20 screen porch, 2
stall attached garage and swimming pool which was
damaged. They carried $100,000.00 on their Building
with Replacement Cost Coverage. They were grossly
under-insured. The adjuster, an independent adjuster,
was quick to offer limits on the building assuming
they wouldn't discover the additional
coverage's available under their policy and
he could settle on that portion through release.
He did his best to settle on the building as
quickly as possible but wouldn't settle until the
contents inventory had been submitted.
He later offered
$32,000.00
ACV on the personal property loss. The
limit for personal property was $50,000.00. No other coverage's were offered by the
insurance company. (Total Loss or
Limit Loss) The check for limits was issued the
same day our letter of representation was received
and our first telephone call advising them of intent
to make claim for the additional coverage's
available under the policy. The insured
had been waiting over a month for that check. It
took us three days to get it.
It cost the insured
$12,000.00 to demolish their building. Their
foundation was a block foundation and only 7' high.
Code calls for an 8' basement. The framing was 2x4
construction and code calls for 2 X 6 framing.
The garage and porch were attached to the main part
of the building so not a detached structure or
covered as an appurtenant structure (Cov B). A
video tape of the demolition of the building clearly
showed the 12 x 20 screen porch was not attached to
the main building but yet denied by the company as
part of the building.
The damage to the pool was
denied as a concrete pad around the pool came into
contact with the foundation walls so that in their
opinion, made the pool part of the building and part
of the $100,000 limit. The owners could not stay in
their home and they moved into their parents home.
They also had 3 dogs which needed to be boarded. The
town of Bristol required prints and a septic design
be submitted before a permit could be pulled on the
project. Three different contractors viewed the site
with the lowest estimate being $132,000.00 to
rebuild a 1200sf house, only. To say money was tight
on this project was an understatement. We needed to
get all of the coverage's available to get the
insured back into their home. The insurance company was
still offering $100,000.00, the limit on this
home.
Immediately after our
representation took place we did a review of the
insured's policy. It revealed the insured had
Inflation Guard Coverage which adds 6% of the
amount carried on the Building limit per year.($6,000.00) The policy also calls for an
additional 5% of Coverage A. Building should you
hit limits for debris removal ($5,000.00) (Form
HO -3). The policy also carries form HO-01-28 a New
Hampshire mandatory endorsement that carries an
additional 5% for the same situation for debris
removal ($5,000.00.) Code and City Ordinance
called for a set of plans before permitting and a
septic design be furnished with these plans. The
plans were $650.00. The septic design was
$850.00 Code called for 2 x 6 construction which
cost an additional $650.00 in lumber costs.
Insulation another $389.00, not to mention the
hardwired smoke detector required, GFI receptacles
and other code issues $1,239.00. The
block foundation was 7' high and needed to be 8' for
code, an additional $1,800.00 was required.
This is an additional $21,578.00.
additional coverage on the building and that's not
all. If settled before our representation the
insured would have received $100,000.00 for the
building. $12,000.00 of that money would have gone
to demolish the building leaving $88,000 to rebuild.
The foundation needed to be replaced but was not covered
under the policy. The blocks were damaged by both water and
heat and collapsed. It cost $7,000.00 to pour a new
foundation. That leaves $81,000.00 for
reconstruction. The amount received after our
representation
was
$121,578.00.
That's a difference of
$40,578.00. We've
already earned our fee (a small percentage of the
loss)
Coverage C. Personal
Property: Our office wrote an ACV for contents of
$67,000. The insurance company wrote $32,000 ACV.
The limit was $50,000.00 The insured received
$50,000.00 after negotiations with the company.
Coverage D. Additional
Living Expenses: Through our representation the
insured received $1,200.00 per month in Additional
Living Expenses while living with family. They were
also given an additional $200.00 per month for
boarding of their 3 dogs.
Coverage B: Other
Structures: the insured's were paid for their pool
and the screen porch. They also received money for
trees shrubs and plants (Landscaping)
In total the client
received $80,000.00 over and above limits.
With regards to the
construction of this home, the only way this building
could have been rebuilt was to sub-contract each
step of the project. General Contractors were
advised of the plan and one chosen by the insured.
Property Adjuster Associates provided construction management
and handled several problems for the insured.
Problems with their bank, their plumber trying to
charge them for a well pump and tank, an electrician
who was released for not making schedule and other
contractor issues.
The insured now lives in a brand
new 2000sf custom home with attached garage (800sf
larger wit garage). A 12 X
20 bonus room, tiled kitchen, 3 extra windows, 3
additional cabinets and many more extras. All of this for under $100,000.00 in re-construction and the insured
ends up with money in their pockets. We did our job!
Where each claim is
different, in one way, they are the same. What is
offered by the insurance company and what our
clients settle for from our representation differ
greatly. Check our references and look at the
differences we have made for them. We stay with you
from foundation to finish!
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