A fire in your home is a very traumatic event. Apart from the sheer shock of the mishap, there is the damage done to your home that severely impacts you and your family members even if you have all been fortunate to escape without injuries.
One common aspect that many homeowners often overlook in the ensuing confusion is that their insurance will cover smoke damages to their home too. In effect, if a fire has erupted in your home and the resulting smoke and soot has damaged much of the interior, you will be able to make a claim with your insurer to recover a major portion of the loss you have sustained to both the building and its contents.
The kind of damage that smoke and soot can do
It is not only fire that can cause massive damage to your property. Smoke and soot can leave behind a lingering smell in your home that can cause respiratory ailments and fill air vents, insulation and other wall cavities. Staining caused by smoke/soot can be virtually impossible to get off the walls and interiors. Valuable items inside your home, such as paintings, photographs, tapestry, furniture, etc. can be irreversibly damaged by soot deposits.
Even jewelry can sustain permanent damage if it is exposed to smoke and soot. Given this, you may have sustained immense damage from the fire in your home even if much of your property has escaped being consumed by the flames.
Smoke damage coverage should be part of your home-owner’s insurance
Many homeowner’s policies include smoke damage coverage especially to cover damage that has destroyed or impacted the interiors of the property or items inside the home. Take a close look at the type of homeowner coverage you have signed up for to verify that this is indeed true in your case. If not, you may want to switch policies or add coverage for this contingency to your insurance plan before such mishaps occur.
In fact, smoke damage coverage should also cover the cost of restoring your home to its pre-fire condition. Keep in mind that cleaning up smoke and soot may require professional expertise which can cost you a pretty penny. If you have a number of valuable items in your home, such as antiques or valuable art pieces, using your insurance coverage for restoration of these assets in event of an accident is also a smart move. It’s covered… use it! That’s what you pay insurance for.
(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
When your insured home has been damaged in a burglary or by natural causes, you may draw solace from the fact that your insurer will cover at least the monetary loss that you have sustained. However, many homeowners get a rude shock when the insurance company seems to be very unwilling to accept their claim, no matter how reasonable it is. This unfortunate state of affairs could confront you as well if you have signed up for coverage with an insurance company that does not really act in good faith.
You have a right to good faith conduct from your insurer
Your insurance company has to protect your interests when you file a claim for compensation as per the terms of your homeowner’s insurance policy. Good faith conduct means that the insurer adjusts your claim in a timely manner. In case there is a reasonable cause to reject it, it is up to your insurer to make this known to you as soon as possible.
In many cases, what really happens is that the insurance company keeps the claim hanging in limbo indefinitely without giving the claimant any clear indication of whether or not the claim will eventually be processed. Worse still, the claimant may not be able to find out why the process is being delayed and how he can hasten it.
When your home has been substantially damaged in a fire, flood or during burglary, such a delay can prove to be much more than just a major inconvenience. Your inability to pay for repair or restoration affects your quality of life severely. Your life cannot go back to normalcy until the claim is paid and you can complete the repairs to make your home suitable for living once more.
What you should do to speed up the claims process
If you are facing inordinate delays in claims processing, you should send a formal query in written form to your insurer. In this written query you should mention the date on which you have made the claim and any subsequent follow- ups you have made over phone or in person. At any point, if you do interact with your insurance company over phone, make a note of the person you have spoken with and the gist of the conversation.
When making a written complaint about delay in claims processing, correspond with your claims adjuster as well as his supervisor and mention the relevant details of your case in the letter. In case you have to take further action, this written record will show exactly how your insurer has acted in bad faith with respect to your claim.
(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
Water can cause significant, “hidden” damages. Water spreads under walls, cabinets, and bathtubs. These areas can become moldy in less than 24 hours. If carpets were wet more than 72 hours they cannot be cleaned due to the bacteria. Consult with a water damage professional and do not simply try to vac the mess with your shop vac.
I’ve been an insurance adjuster for 10 years an and insurance restorator 20 years prior to that. PLEASE… do not take water damages lightly. Many adjusters do not understand the issues and details of water damage. In fact, many water damage contractors, do not know, nor do they follow IICRC or RAI standards when cleaning up water and mold. If you are in a situation or disagreement with your insurance carrier over the damages suffered by a busted / frozen pipe, feel free to call 919-669-9111, anytime to have your questions answered or Contact Us at info@insuranceclaimsgroup.com.
Below is one of thousands of news stories about the subject. It’s almost an epidemic this winter.
“Frozen pipes lead winter-related insurance claims
Sunday, March 16, 2014 8:12 PM
BY STEPHANIE GROVES
Staff Writer sgroves@delphosherald.com
DELPHOS — The unyielding winter weather has taken a toll on every facet of our lives; from stressful driving conditions to the potholes in the roadways to the disastrous outcomes of frozen water pipes, the weather weary just want to put winter behind them.
Unfortunately, that’s not so easy for households who have or are still experiencing the effects of winter-weather damage to their homes.
Gilden Insurance owner Jerry Gilden said he has seen an increase in claims due to bursting water pipes this winter.
“We have had a dramatic increase in these types of claims as compared to the few previous years,” Gilden said.
Owner of Schmit, Massa and Lloyd Insurance and principal agent Bill Massa said with weather like this, it is commonplace to see exposed plumbing cause pipes to burst, especially with the zero and sub-zero weather the area experienced in February.
Gilden said claims of snow collapses have not been a big problem since up until the last storm — which was a wet and heavy snow — most of the accumulations have been lighter in weight.
“Any structures that were marginal or could sustain damage probably took a hit back in June of 2012,” Gilden reasoned. “The wind probably took care of them back then.”
Massa reported his office has not seen any issues with damage to roofs from the weight of snow or ice this winter. He said as a preventative maintenance measure, many folks shovel it off to be safe.
“The weight of heavy snows on older roofs can cause structural impairment and damage joists,” Massa detailed. “In such cases, homeowners will see water appear on their ceiling.”
Karen Dickman of Dickman Insurance said over all, the industry was hit pretty hard with frozen pipe claims and this winter, her office has handled a few broken/burst water pipe claims. In addition, one individual called about water backing into the house from the gutters.
“They sustained minor damage to a ceiling in their living room,” she said. “It did not amount to enough to file a claim.”
Massa said when water gets trapped in the gutter and freezes, it expands and ice is pushed into places it should not be; and once it starts melting, that’s when we see the water damage.
Gilden said there have been a few calls about water backing up in gutters — gutter dams — and in basements.
“Tiles around the house can freeze and block the water being pumped out by the sewer pump,” Gilden detailed.
Dickman said with the last big thaw, one individual called about water backing up in their basement. She said it’s good preventative maintenance to have a spare sewer pump on hand.
“Equipment like that only lasts so long and with the amount of work it was doing, it gave out,” Dickman said. “More often than not, that’s when it happens, during a big thaw or rain event.”
She said one thing they worry about is fires when temperatures get extreme. Fortunately, the company has had no claims due to fire.
“Space heaters and furnaces work overtime and sometimes do not stop,” she said. “People should have their heating systems checked during the latter part of the summer or early fall.” “
(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
A fairly new and significant issue affecting insurance carriers and their policyholders is mold. For the past 15 years or so, the awareness of mold has escalated in major proportions. The cost of this awareness has skyrocketed tremendously. The world wide web and the media have fueled this awareness making policyholders far more diligent in locating and removing mold than they ever considered before. Due to such, entire mold remediation and mold education industries have awakened. As with any expensive risk or peril, property insurers have swung another “left hook” by adding exclusions, endorsements, and uncovered limitations to insurance policies they sell.
“Conclusion – Insureds faced with mold claims should evaluate very carefully what property is damaged and the appropriate level of remedial measures. To the extent that moving out of the insured premises is necessary, the insured must make a satisfactory claim, supported by admissible expert evidence, that the move was necessitated by tangible damage to insured property. While moving out of potentially mold-infected premises may make business sense from the standpoint of protecting employees and making sure employees are comfortable with the working environment, a business decision is not necessarily covered by property insurance.”
Is Mold Covered In My Policy?
Is it covered or is it not covered? Your policy and endorsements will tell the story. For example; NC has an endorsement (modified much over the years) that in summary means, “Seepage over weeks, months, or years that causes rot or mold is excluded, unless it’s the result of a covered loss”, then there is a limit of $5,000. Where GA policies excludes most mold issues, unless the mold is a result of Fire. Then there is no limit AT ALL. So, it’s very important to know your policy. In the event of a loss you should request in writing a “Certified True”copy of your policy from your carrier. If the language of the policy if foreign to you, consider help from a public adjuster or insurance claims consultant.
Inspect your property once or twice a year for all types of maintenance as well as mold issues. Preventive maintenance for homes and buildings are just as import as that 3,000 to 5,000 mile oil change we diligently provide for our engines… it’s a hell of a lot cheaper to catch it early too!
(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
The insurance industry has the best business model in the world. Imagine owning a company where:
Client pays up front
Insurance Company benefits from that up front payment
Loss occurs
– Policyholder expects to be paid for losses
– Insurance company hits the breaks
The policy purchased by the policyholder is know as a “Contract of Adhesion”. This means, that the contract (policy) is a standard form contract drafted by one party (the party with the stronger bargaining power – CARRIER) and signed by the weaker party (usually a consumer in need of goods or services – POLICYHOLDER), who must adhere to the contract and therefore does not have the power to negotiate or modify the terms of the contract. Being that the policyholder cannot negotiate the terms or make revisions to the policy, they must “adhere” to what it says word=for-word. Sounds unfortunate for the policyholder. However, the Carrier must adhere as well. This means anything that’s ambiguous or unclear goes to the default of the party who did not generate the contract (the POLICYHOLDER).
With that being said, and the fact that the insurance company (carrier) is the stronger party who has collected money from the policyholder, they have a duty to protect that policyholder and provide any and all available coverage to each client.
“The primary duty of the [insurance company] claim representative is to deliver the promise to pay. Therefore, the [insurance company] claim representative’s chief task is to seek and find coverage, not to seek and find coverage controversies or to deny or dispute claims.”
James J. Markham et al., The Claims Environment, 13 (1st ed. 1993).
Seek And Find All Available Coverage
If the insurance adjuster and the carrier’s responsibility is to seek and find all available coverage, then why does it seem that with many claims the carrier is trying to find fraudulent activity by the policyholder? Investigations, depositions, waiver of right forms, release of all claim forms, etc. Well, it must be all part of the “Delay, Deny, Defend” model followed by many of the carriers that was designed to increase their bottom line… but that’s another story. Not “all” carriers follow this model, however, most of the “Big Boys” do!
(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
