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So here's a fun one. Back in the winter of Feb 2011, there was a giant ice storm/blizzard, and my home had some ice damage. I called my insurance company ~3/15/2011 (Selective) and told them I might want to make a claim.

They sent a guy out, an obnoxious one at that, who basically didn't want to pay me anything even though there was some fairly significant damage (leaks in multiple places in the house). He said things like "people getting something for nothing" etc. He looks everything over, takes notes, then says he'll follow up.

I ended up quitting my job, and taking a new one in AZ April 1, 2011. Somehow there were some letters sent from him to my house that I didn't get, or were forwarded much later to me. I never said I wanted to proceed with the claim or anything.

I thought I had a $1k deductible, but turns it out it was $2500. The damage was probably $5k-10k. My dad was reroofing his multi-million dollar place and got the same roofer to cheaply stop by my place and fix the roof for ~$2500.



Fast-forward to today, and I'm getting a policy on my home purchase here in AZ. They check for previous claim history for 5 years. A payment of $1114.88 (3614.88 less 2500 deductible) was made and a claim against the property.
I never received the check, never said I wanted to proceed with the claim, never paid a deductible, and I confirmed it was never cashed with Selective.


What should I do at this point?
Do I just have them resend the $1114.14?
Do I have them void the claim and check?

I think that their total claim valuation of $3614.88 is LOW. I have pictures of the workers repairing the roof, and the wood is badly damaged/soaked and had to be replaced. Something that the estimator did not account for. Is it "free money" that I should get, even though it should be higher or what?

The claim doesn't seem to currently affect my insurance quote though on my AZ property ($1052/year).

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The pics show some issues that had nothing to do with the winter storm. Rotten wood is not the result of a short-term re... (more)

jumi (Mar. 26, 2013 @ 11:42a) |

You're probably right.

Al3xK (Mar. 26, 2013 @ 11:56a) |

My opinion as well - looking at that wood, it was not damaged by a single storm. The storm may have been what revealed t... (more)

nyarrow (Mar. 26, 2013 @ 5:00p) |

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So you never got any notice your claim was approved , denied , estimates from the insurer calculating your payment etc?

I'd have a bad faith insurance attorney review this - chances are many errors were made which will entitle you to a far larger settlement

SUCKISSTAPLES said:   So you never got any notice your claim was approved , denied , estimates from the insurer calculating your payment etc?

I'd have a bad faith insurance attorney review this - chances are many errors were made which will entitle you to a far larger settlement


I can say I never received anything, but I can't say what may or may not have happened to the mail. My sister moved into the house shortly after I moved, and I setup mail forwarding to AZ. I basically just stopped talking/contacting the guy thinking that I'd get around to it after I got settled.

He apparently just decided to file the claim, decided on an amount, and decided to mail a check.

Another thing, there might be mold on the sheetrock from this. It could also be just black tar that seeped through. Now I'm pretty sure I can just cut the sheetrock out and replace it and it's fine...but I'm not sure what that does to the value of the claim (over 1 year ago). Can they claim it's unrelated?

The $2300 I spent was cash to some hardworking Hispanics. I didn't get a receipt for it, but I do have dated pictures of the roof being torn apart.



I'm still OK voiding the entire claim if the claim isn't worth it. It'll have cost me about $3300 total out of pocket. I'd have expected a $7-10k check though.

Could the check be even more with the bad faith claim or does a bad faith attorney just get me what I was originally supposed to get?
Or since this is more of an egregious error...are there penalties?
Will this show up on my claim report, if i win some amount with an attorney, as a high dollar claim?

Lesson #1: Change your address with each company you do business with when moving (banks, insurance, brokerage, etc). Don't rely on someone else to forward things to you. The post office actually WILL forward thing to you for six months, and usually does a fairly good job, but still, just change it direcctly with each relevant company.

Kanosh said:   Lesson #1: Change your address with each company you do business with when moving (banks, insurance, brokerage, etc). Don't rely on someone else to forward things to you. The post office actually WILL forward thing to you for six months, and usually does a fairly good job, but still, just change it direcctly with each relevant company.

Lesson #1: Never have mail sent directly to your house. Always use a PO box or UPS box since you can put "suite #" and get sent stuff you can't get sent to PO boxes.

Al3xK said:   SUCKISSTAPLES said:   So you never got any notice your claim was approved , denied , estimates from the insurer calculating your payment etc?

I'd have a bad faith insurance attorney review this - chances are many errors were made which will entitle you to a far larger settlement


I can say I never received anything, but I can't say what may or may not have happened to the mail. My sister moved into the house shortly after I moved, and I setup mail forwarding to AZ. I basically just stopped talking/contacting the guy thinking that I'd get around to it after I got settled.

He apparently just decided to file the claim, decided on an amount, and decided to mail a check.

Another thing, there might be mold on the sheetrock from this. It could also be just black tar that seeped through. Now I'm pretty sure I can just cut the sheetrock out and replace it and it's fine...but I'm not sure what that does to the value of the claim (over 1 year ago). Can they claim it's unrelated?

The $2300 I spent was cash to some hardworking Hispanics. I didn't get a receipt for it, but I do have dated pictures of the roof being torn apart.



I'm still OK voiding the entire claim if the claim isn't worth it. It'll have cost me about $3300 total out of pocket. I'd have expected a $7-10k check though.

Could the check be even more with the bad faith claim or does a bad faith attorney just get me what I was originally supposed to get?
Or since this is more of an egregious error...are there penalties?
Will this show up on my claim report, if i win some amount with an attorney, as a high dollar claim?

Successful bad faith cases typically result in jury verdicts of 6/7 figures. Settlements before trial are often far in excess of your claim value . At least that's the way it works in CA, consult a few bad faith attorneys local to your property and see what they say, it typically costs nothing for a consult and they usually work on contingency

Whats with all these life 101 questions? Call the insurance agent you had at the time, explain the situation to them, and take it from there.

Do I just have them resend the $1114.14?

That's what I'd do. It's simple and painless.

I suppose the core of the question is, is a $3600 claim (where I get 1114) worth having on your record? They typically check the number of claims per 5 years (this one is on record a little over 2).

AND he low-balled the crap out of the claim and I've had no chance to respond...he just filed and sent a check. It should have been $7-10k.

I'll talk to an attorney tomorrow and just see what they say.

It's going to be a pain to get it off your CLUE report.
Get them to re-send a check, heck it may show up somewhere as "unclaimed" funds.
Bad faith? First thing they'll say is "lost in the mail" - which is hardly bad faith...

Bad faith is not re-issuing.

I was thinking the bad faith would be filing the claim when I didn't want to or the low payout. It is definitely more than $3600 in damage. I might just have them re-issue the check, mainly because I don't have the receipts for the work done. Just pictures and my word, but then again I got the work done SUPER cheap...which shouldn't affect the true payout.

Al3xK said:   I suppose the core of the question is, is a $3600 claim (where I get 1114) worth having on your record? They typically check the number of claims per 5 years (this one is on record a little over 2).

AND he low-balled the crap out of the claim and I've had no chance to respond...he just filed and sent a check. It should have been $7-10k.

I'll talk to an attorney tomorrow and just see what they say.


Given that you paid $2500 to repair the house, how is it you think you "deserve" thousands more?

Al3xK said:   I was thinking the bad faith would be filing the claim when I didn't want to
An adjuster doesnt come out to your house when you are thinking about filing a claim. At that point, you've filed the claim and need to stay on top of it. Ya know, for future reference.


Damage (315.57kB)
Disclaimer
~$2300 was a deal because my dad was spending $40k + 100k on other stuff, but that was only the roof. Not the interior damage. Here is one of the sections that was damaged (only pic I currently can find).

There is a closet that was damaged and then a huge section in an upper bedroom. And the mold is the main reason.

I also didn't get the gutters fixed or the siding done yet. I just spent $2300 to stop the leaking.

So the roofing would have cost maybe $5k if I'd called up 3 roofers.

Because I paid $2300 doesn't mean that's what insurance should pay me. What if I bought the shingles myself and did it for $200...do I get $200?


Glitch99 said:   Al3xK said:   I was thinking the bad faith would be filing the claim when I didn't want to
An adjuster doesnt come out to your house when you are thinking about filing a claim. At that point, you've filed the claim and need to stay on top of it. Ya know, for future reference.


I didn't realize that. I just called my insurance agent and said I was considering making a claim, but wasn't sure how much it'd cost. He said they could send somebody out to take a look at it.

I suppose this is a learning experience.

jumi said:   Al3xK said:   I suppose the core of the question is, is a $3600 claim (where I get 1114) worth having on your record? They typically check the number of claims per 5 years (this one is on record a little over 2).

AND he low-balled the crap out of the claim and I've had no chance to respond...he just filed and sent a check. It should have been $7-10k.

I'll talk to an attorney tomorrow and just see what they say.


Given that you paid $2500 to repair the house, how is it you think you "deserve" thousands more?

He's just being overly straightforward - $2500 is what his dad charged him for rolling the work into his own significantly larger project.

Al3xK said:   ~$2300 was a deal because my dad was spending $40k + 100k on other stuff, but that was only the roof. Not the interior damage. Here is one of the sections that was damaged (only pic I currently can find).

There is a closet that was damaged and then a huge section in an upper bedroom. And the mold is the main reason.

I also didn't get the gutters fixed or the siding done yet. I just spent $2300 to stop the leaking.

So the roofing would have cost maybe $5k if I'd called up 3 roofers.

Because I paid $2300 doesn't mean that's what insurance should pay me. What if I bought the shingles myself and did it for $200...do I get $200?


Glitch99 said:   Al3xK said:   I was thinking the bad faith would be filing the claim when I didn't want to
An adjuster doesnt come out to your house when you are thinking about filing a claim. At that point, you've filed the claim and need to stay on top of it. Ya know, for future reference.


I didn't realize that. I just called my insurance agent and said I was considering making a claim, but wasn't sure how much it'd cost. He said they could send somebody out to take a look at it.

I suppose this is a learning experience.
Another option not yet mentioned (and I'm not suggesting one thing over another) is to formally withdraw your claim. But who knows if it's still at a point where that's even possible, or if it'd require as much legal action to undo as pursuing the bad faith claim.

Op at this point forget about trying to get the claim
Off your clue report. Whether they paid $2, $1114 or $500,000 its still going to Be on there

Sometimes even inquiring , without ever filing a claim for Damage, appears on your insurance reports .

The reason for this is so that future insurers can see this problem, and so you don't ask a future insurer to cover pre existing damage

How widespread was the damage from the specific storm, meaning throughout your area/state, not just on your property? If enough people (thousands) had damage from the same storm, it's possible your claim should have been considered to be part of a catastrophic event, and therefore shouldn't count against your claim history (and probably shouldn't have incurred a deductible either). I believe the determination as to whether something's a cat event or not is made by the state insurance commission, not the insurers. Not sure if there's any way to look up a particular weather event this long after the fact.

I'm also curious if your agent happens to do significant business with other family members of yours. The reason this could be important comes down to leverage. You say that you only spoke with your agent (as opposed to Selective's claims dept) and said that you might want to file a claim, and he offered to send someone out to have a look without explaining to you that you were actually opening a claim. In this scenario, it's potentially his fault that he did not clearly explain the consequences to you, and his errors and omissions coverage might come into play. Of course, this type of thing doesn't reflect well on an agent so unless you have written documentation of your exchanges with him it will come down to your word against his, on something that happened 2 years ago. Then again, if by any chance your father, who from your posts in this and other threads apparently owns a multi-million dollar property and strip mall(s), has significant policies on this agent's book of business, said agent might be more willing to take a small hit on this one for some good will with the family.

I was told I could talk to the agent and work on "voiding" the claim. If that means they just don't give me money, and it stays on the CLUE, screw that.

My dad unfortunately doesn't do business with them. He's an insurance agent my realtor recommended.

It was a blizzard and the state told people to stay off the roads. My work was canceled, power was out for 50k residents at one point, Purdue canceled classes (which they almost never do). Personally, my cars were frozen to the ground and I couldn't get in them. The tires were in about what seemed to be around 1-2 feet of ice. I just stayed inside and watched movies with the GF. It was a blast lol.

http://www.theindychannel.com/weather/-potentially-catastrophic-...
http://en.wikipedia.org/wiki/January_31_%E2%80%93_February_2,_20...

I'm searching the "Indiana Department of Insurance (IDOI)" website now, but I'm not sure where they'd list it.

FEMA doesn't have any disasters listed here (http://www.fema.gov/disasters?field_state_tid=56&field_disaster_... which is a neat page for searching disasters for others to bookmark.

i'm surprised no one has mentioned the possibility that a fradulent claim was filed against OP's policy without their knowledge. ins agent was probably in on the scheme, so tread carefully. they probably sent the "adjuster" to make it look like you were filing a claim. the adjuster may well have stopped by the house, saw the roof work being done, and thought they had could use that work as "proof" that your "claim" was paid. by the way, the psychological term for the "adjuster's" accusation that you were "getting something for nothing" is projection.

if you suspect fraud, then you should contact the ins agent for your new house, and tell them that you suspect the prior claim to be fraudulent. then write your old agent and demand in writing all documentation relating to your "claim" including a copy of the canceled check paid to you.

OP, over two years ago you had this damage, and only fixed part of it, ignoring damaged gutters, siding, and interior water damage w/mold? You paid cash and have no receipts for the partial repairs you did complete? Is a permit required for re-roofing (it is in my area), and if so did you pull a permit?

Sounds like a lot of damage -- why on earth have you done so little for so long? This sort of major loss is exactly what insurance is for. Your sister lives in the place now -- who owns it or is on the mortgage? You need to get the property fixed -- both to preserve whatever equity you have in it (mold, water damage, bad siding, and bad gutters isn't going to make your house a hot resale commodity) and for the health and safety of your sister- pursue getting the claim reopened and all of the work done -- although that might be tough given that you've inexplicably done nothing about most of the damage for more than two years!

I had most of the other stuff fixed already too, but my brother is a contractor, and I had him completely remodel a bathroom ($6k+) and fix the drywall stuff while he did it, so it was just rolled into that project. The gutters are just dented/saggy, so not a big deal.

I spoke with a woman from the fraud department at 6am AZ time because she's on the east coast...sigh. Apparently even talking to them means it's a claim and it probably won't come off my CLUE report. They can see in their system that the check was never cashed, so it's not fraud. The adjuster shouldn't have made the claim.

Here's a weird thing...on the phone (now she could have been mistaken) a woman told me their report showed he met with me 4/8/11 for the claim, and I have a 1-way flight showing I was in AZ since 4/4/11. I doubt this means much though because I did meet with an adjuster.

I'm just ticked they sent a check without giving me the opportunity to dispute (AFAIK).

So now I have to either accept the check, or figure out some way to argue for more money.


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Found pics. If you have an iPhone, I highly recommend http://deciphertools.com/ to search/extract your conversations/pictures/videos/etc.

The pics show some issues that had nothing to do with the winter storm. Rotten wood is not the result of a short-term recent infiltration of water from a big storm. That wood rotted over a number of years from prolonged water exposure -- your roof (which looks pretty shot from age) was leaking long before the storm -- there's a reasonable chance that some of the internal water damage also predated the storm.

Given that, and the reality that you fixed the roof and other issues already and the storm happened two years ago, I'd be surprised if you would have any success reopening the claim -- at this point I'd just take the check.

You're probably right.

jumi said:   The pics show some issues that had nothing to do with the winter storm. Rotten wood is not the result of a short-term recent infiltration of water from a big storm. That wood rotted over a number of years from prolonged water exposure -- your roof (which looks pretty shot from age) was leaking long before the storm -- there's a reasonable chance that some of the internal water damage also predated the storm.
My opinion as well - looking at that wood, it was not damaged by a single storm. The storm may have been what revealed the damage, but the rotten wood is evidence of a long-standing problem. It is likely that the failure of the rotten wood is what caused the interior damage as well. The weight of the ice was the proverbial "straw that broke the camel's back" - I would say to take the check for $1100 and run...

BTW - this is probably why the insurance adjustor (unprofessionally) complained about you trying to get "money for nothing". Legally, they are obliged to replace it (the storm did contribute), but that doesn't mean that the adjustors are always happy about it. It also doesn't mean that they are on the hook for replacing other damage that was revealed by (but not caused by) the storm...



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