Adjuster Estimates

Tags - Popular | FAQ  

PrevPrev Go to previous topic
NextNext Go to next topic
Last Post 05/17/2011 3:10 PM by  Ray Hall
EPDM preexisting damage and wet insulation
 16 Replies
Sort:
You are not authorized to post a reply.
Author Messages
Allfor1
Guest
Guest
Posts:1


--
05/01/2011 4:16 PM

     I am working a loss for hail.  The roof is EPDM and while there is no hail damage there is 2 places where the membrane has been compromised by flying debris.  There is evidence of preexisting hail as the wall coping and all of the vents all show signs of impact.  The last storm that went through prior to the current DOL was last September.  This is an old roof with alligatoring and some blisters.  Evidence of repairs are all over.   Along the rear elevation where the roof meets the parapet wall the membrane has been ripped away.  This is a maintenance issue and not wind related.  I come to find out the roof has been leaking in multiple portions of the strucure predating the date of loss.  I don't know how to progress.  While I would certainly believe we owe to patch the hole's it's impossible because the insulation on the entire roof is most likely wet due to other issues.  I don't know that this will be denied as this is a LARGE commercial policy with several other locations.  While I can't replace the entire roof since the insulation is probably wet on the entire roof what is within reason to progress this loss.

     

    Any thoughts, theories, and advice will be appreciated.

    Hope everyone is busy or will soon be!

    0
    Ray Hall
    Senior Member
    Senior Member
    Posts:2443


    --
    05/02/2011 11:12 AM

    This is always a problem on the roofs with new and old damage. I would write this up to use the torn membrane from the flying debis and kinda over pay in this area on the wet insulation, try to seperate all peril damage from wear and tear get the cost for all repairs, get permission to settle for cost of repairs from the carrier. I would get a good commercial roofer to back up your thinking.

    0
    Leland
    Advanced Member
    Advanced Member
    Posts:741


    --
    05/02/2011 3:21 PM
    I agree with Ray and I would suggest you need to get a roofer out there ASAP. Call the carrier right away. Let's say it need's a new $40,000.00 roof because it is old and poorly maintained. The direct damage from wind could be patched for $2000.00. The wet insulation is not related to the wind damage. If you don't get a professional roof opinion, the insured might have it all torn off and fixed by next week. Then they will ask for the full $40,000 and you will have very little evidence to deny the claim. Since you already looked at the roof, the insured has met their policy requirement to "exhibit" damages. Did you tell them to wait a few days before tearing off the roof? What will you do if the insured gets a roofer's opinion that says the roof needed to be replaced due to the recent wind, and the work is already completed? How could you, a non-roofer, argue with a licensed roofer and win in court? But you also have to consider that maybe the roof really does have more damage than you realize from the recent wind. Maybe the part you thought was maintenance was actually from wind. Your expert might agree that the insured is owed a new roof due to wind, and then it would be fair to pay them, perhaps with a lot of depreciation. But if there is a potential $38,000 disagreement like in my example, it is only prudent to obtain an expert opinion before the roof is replaced. Or at least ask the carrier right away if they want one. They can always say no, it's their choice. I often make that phone call while I am still standing on the roof.
    0
    Leland
    Advanced Member
    Advanced Member
    Posts:741


    --
    05/02/2011 6:58 PM
    I would like to clarify that my answer depends on whether this is a typical "daily claim" or one of the recent cat claims. In a cat claim you may be expected to just recommend payment or issue payment based on your opinion alone, and move on to the next claim, leaving someone on the clean up crew to deal with the aftermath. When I worked Hurricane IKE commercial claims, I was never expected to get an expert roof inspection. But It is expected all the time on daily claims.
    0
    Leland
    Advanced Member
    Advanced Member
    Posts:741


    --
    05/02/2011 7:19 PM
    This is what a professional roof inspection report looks like for a simple roof leak. This is not the entire report, I obviously left out the photos. The author of this report has experience as the owner and license holder of a roofing contractor, and has extensive experience in courtrooms. The inspection company is not in the business of doing repairs and they do not try to get the repair work- they only do reports. A report from Bubba the roofer, written by hand, doesn't really cut it compared to this. This report was probably about $300.00, which in Los Angeles is dirt cheap. This is the quality of work that the insurance carriers usually expect on daily claims.




    INTRODUCTION: A mineral-surfaced built-up roof, BUR, has been installed on this two-story residence and detached garage. Water incursion was reported throughout the dwelling.
    The age of the BUR was unknown at the time of our inspection. Our visual observations of the roof areas estimate their age to be approximately 15 years. A properly installed and maintained BUR in this region should have an expected service life of 15 years. Areas of the roof have been provided a modified bitumen material in a partial overlay or re-cover in an attempt to repair the aged BUR.

    PRELIMINARY FINDINGS:
    No damage to the BUR membrane was observed as the result of wind or storm related events or the result of impact from a foreign object.
    The built-up roof areas were observed to have deficiencies associated with installation, deterioration, and a lack of regular maintenance that promote the accelerated deterioration of the BUR and/or allow moisture migration beneath the roof assembly, which include, but are not necessarily limited to:
    • Missing coping metal along the parapet wall.
    • Deteriorated or missing flashing seals at vertical plumbing vent pipe penetrations.
    • Ponding water at the drain areas.
    • Insufficient staggering of the BUR headlaps during the installation process.
    • Debris present on the surface of the BUR membrane.
    • Vertical protrusions without the benefit of a sheet metal flashing.
    • Aged and deteriorated condition of the mineral-surfaced BUR membrane.

    The remedial repair attempts are not positioned or adhered in accordance with accepted trade standards.

    CONCLUSIONS:
    The source of the reported water incursion was determined to originate from the numerous aged and defeated conditions on the mineral-surfaced built-up roof membrane. Evidence of ponding water around the roof drain areas and/or insufficient flashing details are contributing factors to the purported moisture intrusion on the front right of the building. A competent Tradesperson(s) would be reluctant to repair the BUR as there are several conditions that if provided restoration would only obtain limited service at best. After restoration attempts of the roof are completed there may be the perception of inherited liability when the roof eventually fails, further preventing Competent Tradesperson(s) from offering service for remedial repairs.

    An overview of the mineral-surfaced built-up roof membrane installed on the residence is provided in PHOTO 1 and the detached garage is presented in PHOTO 2. The roof was observed to be in a below average condition at the time of our inspection, with multiple areas of ponding water contributing to widespread granule loss that was identified throughout the BUR membrane. The exposed fiberglass matting or scrim is not weatherproof and can be inundated with moisture during periods of inclement weather. Numerous previous repair......

    ...................The scupper drain area above one of the areas of reported water incursion at the rear left portion of the residence is featured in PHOTO 3. Accumulated silt and debris present in the waterway surrounding the drain is indicative of standing water in this area after the cessation of rainfall activities. The elevated position of the drain in relation to the surrounding roof deck may serve to promote the accumulation of water in this area.
    Most manufacturers of asphalt or bituminous based roofs encourage that moisture be displaced away from the BUR within 48 to 72 hours after inclement weather. Staining and/or silt accumulations on the roof are an indication that this process takes longer than the recommended 72 hours. A similar condition is also visible on the scupper drain at the front of the structure, as illustrated in PHOTO 4, and is characteristic of the condition of the drain areas on the dwelling.


    The through-wall scupper at the rear right of the dwelling is depicted in PHOTO 5 and PHOTO 6. The displacement of the coping metal covering the parapet curb area has created a void at the top of the curb as it meets the flange of the scupper drain. A view of the exterior wall in PHOTO 6 details the encasement of the drain in mastic as it exits the building wall. This is not necessarily an intended application for mastic as over time cracks will develop in the mastic that eventually permits the migration of moisture into the building wall through this exchange. The use of mastic as a substitute for an adequate flashing assembly in this location is not consistent with local sheet metal trade standards.


    PHOTO 7 reveals that the headlaps of the BUR cap sheet surface are not adequately staggered the manufacturer recommended 36 inches. The less than adequate separation of the headlaps can result in water wicking into the membrane in periods of inclement weather. This condition was identified in various areas of the BUR assembly.

    PHOTO 8 captures that portions of the roof that have been provided an overlay of a modified bitumen material. The modified bitumen roof, MBR, installations have not been positioned or adhered in accordance with accepted trade standards. There are voids, opening, overheated membrane, and buckles developing in the overlay applications that can allow moisture below the roof. Continuance of remedial repairs will not be cost or service effective due to the depleted condition of the BUR.

    The vertical plumbing vent pipe penetration featured in PHOTO 9 has a missing and/or depleted seal at the transition with the sheet metal roof flashing as well as a displaced vent extension and cap. The roof flashing illustrated in PHOTO 9 has been surface applied and sealed at the perimeter with mastic. This installation practice is outside of recognized application standards for this region. A vent penetration flashing on the detached garage is displayed in PHOTO 10 and lacks an adequate seal at the exchange with the plumbing vent pipe protruding through the deck. A neoprene collar or adhesive seal is required to prevent moisture migration into the residence through the pipe.

    Roof penetrations at various locations of the residence have been installed without the benefit of a sheet metal roof flashing as demonstrated in PHOTO 11 and PHOTO 12. The use of mastic as a surface flashing is not an industry accepted alternative to a sheet metal flashing and should be considered as a source of potential moisture incursion. The MBR overlay captured in PHOTO 11 displays the improper positioning and adhering of the remedial repair attempt. The MBR was overheated and roughly trimmed around the penetration. This suggests that the repairs were not provided by a journeyperson(s).

    The aged and deteriorated condition of the BUR membrane on the residence is illustrated through the cracking exhibited in PHOTO 13 and the blistering depicted in PHOTO 14. Blisters occur when moisture influences migrate beneath the roof assembly and turns to air during the drying cycle. The air bubble created forces the separation of the membrane from the underlying base sheet and/or roof substrate. The cracking present in the membrane in PHOTO 13 is an indication that the roof is not performing as intended. Water may migrate beneath the roof assembly through voids or deficiencies present in the BUR membrane, eventually appearing as moisture incursion at the interior of the dwelling.

    Accumulated debris and/or abandoned items are present on the surface of the BUR in PHOTO 15. The presence of debris on the surface of the roof can damage the roof membrane and should be removed as a part of general care and maintenance. Debris was also observed on the roof of the detached garage.


    A satellite dish has been surface-mounted to an interior parapet curb in PHOTO 16. Although the dish does not penetrate the deck of the BUR, the application of exposed fasteners through the roof assembly can result in the premature deterioration of the underlying roof components along the parapet curb. The adjacent MBR has installation deficiencies such as wrinkles and open laps.

    SUMMARY & COST ESTIMATES There was no visible damage to the mineral-surfaced BUR and/or related components as a result of storm-related activities or impact from a foreign object. The reported water incursion on the front right of the building was determined to result from the aged and defeated condition of the mineral-surfaced built-up roof membrane. While continued remedial repairs could be made to rework the area above the reported water incursion, a competent Tradesperson(s) would be reluctant to further repair the BUR as there are several conditions that if provided restoration would only obtain limited service at best. After restoration attempts of the roof are completed there may be the perception of inherited liability when the roof eventually fails, further preventing Competent Tradesperson(s) from offering service for remedial repairs. The approximate cost to remove and replace the BUR, depending on the materials selected and methods of installation, if done by a competent, reputable, and licensed California C-39 Roofing Contractor, should likely not exceed $14,800.00.
    This cost estimate and the recommendations put forth do not necessarily include any structural repairs and/or upgrades or the encountering of any hazardous material or conditions that may be revealed in the course of remedial work. Any remedial repair work to be attempted would likely carry a workmanship type warranty only. All work is recommended to be completed by a licensed, California C-39 Roofing Contractor in accordance with accepted roofing practices.
    0
    Catmandale
    Guest
    Guest
    Posts:39


    --
    05/02/2011 9:21 PM
    I would also consider visual inspections and stain mapping from below and a competently administered IR Thermography inspection.
    0
    Ray Hall
    Senior Member
    Senior Member
    Posts:2443


    --
    05/03/2011 11:08 AM

    I thought of this yesterday but did not mention it. Many commercial losses are "not expected to be paid from the insured standpoint";"it,s just a trial  balloon" and the owner, property manager will take the adjusters inspection and report in a "business" conversation and the matter is closed. Many will take the first offer and lagniappe and replace a worn out roof wirhout insurance dollars.

    I would never do infra red test UNLESS I accept all wet material as storm damage.

    None of my comments apply to dwelling storm claims, commercial only.Both roof claims, but night and day on the first inspection and scope of insured loss from a peril damage.

    Commercial adjusters with many years experience should handle these type claims to conclusion and keep them out of the courthouse and the expense of hired experts(that will be backfire on the carrier).

    0
    Catmandale
    Guest
    Guest
    Posts:39


    --
    05/04/2011 8:59 PM
    I hear what you are saying Ray, and I would consider my responsibility as the adjuster to make every effort to do the mapping myself by accessing as many areas as I can reasonably do. I keep overalls and boots with me, along with flashlights, etc... so that I don't have to call a specialty expert until I have done what I can.

    And I would definitely review sample work before recommending hiring anybody. "Expert" is a very broad term. Heck, I am even considered an expert at one or two things ;)

    My thought was that I would like to see if there was a continuous route of water flow from the impact area or more than one source.
    0
    CatAdjusterX
    Veteran Member
    Veteran Member
    Posts:964


    --
    05/06/2011 1:52 AM
    Posted By Catmandale on 02 May 2011 09:21 PM
    I would also consider visual inspections and stain mapping from below and a competently administered IR Thermography inspection.



     

    Thermography inspection is a dangerous way to go and as Ray stated be prepared to buy "ALL" wet material. I did a class on this with Rimkus on Monday and the engineer stated that it's extremely difficult to differenciate from the old, from the not so old, to the new. Temperature variance can be very subtle from old to recent moisture. 

    "A good leader leads..... ..... but a great leader is followed !!" CatAdjusterX@gmail.com
    0
    Leland
    Advanced Member
    Advanced Member
    Posts:741


    --
    05/06/2011 4:34 PM
    Certainly using a moisture meter on the ceiling and making notes on a sketch diagram is cheaper. Yes it's true that the IR thermography can't tell you what is new water vs old, but I think the idea is to show exactly WHERE the water is, to help determine its source.

    Lets say the roof has a scupper drain on each of the 4 corners and the wind damage is smack in the center of the roof.

    If the moisture testing (of whatever type) shows that the ceiling is very wet in each of the four corners, wet right in the center for 10 sq ft, and totally dry in between the 5 wet spots, then clearly the wind damage did not result in more than 10 sq ft of moisture and the corners of the ceiling are wet for some unrelated reason, like a problem with the construction or design of the drains. You could have an even more obvious example, with one end of the ceiling wet underneath a worn out/previously patched roof, and a ceiling stain underneath some wind damage clear on the other side of the building 100 feet away. The thermography would merely document what is already obvious to anybody with common sense but the benefit is the majority of the water damage can be correctly denied without risking a bad faith claim and also the claim will stay closed.

    Another example would be a kitchen with wet flooring, dry walls, and a wet ceiling. Obviously the wet ceiling would not be related to the leak at the sink, because water generally would not migrate up the wall to the ceiling, wet the ceiling but dry out on the walls, leaving the ceiling still wet. Such as scenario is virtually impossible. Obviously in this scenario there would most likely be TWO leaks, perhaps one covered by insurance and the other not or at least a separate claim.

    A very detailed set of moisture readings with a drawing would show the pattern of the water but a thermography photograph would be much easier to understand with one glance.

    I don't understand why you would say Thermography Inspection would be "dangerous". If the results are inconclusive or in favor of the insured getting a new roof, then perhaps he should get a new roof. Using an extra investigation tool wouldn't be "dangerous" in my opinion. The only thing that would be "dangerous" would be to rely on the results to deny the claim when the results weren't real clearcut.
    0
    ChuckDeaton
    Life Member
    Senior Member
    Senior Member
    Posts:1110


    --
    05/07/2011 12:16 AM
    Thermography does not detect moisture, Infrared Thermography measures temperature. Variances in temperature may indicate the presence of moisture. A Thermography photograph would show the pattern of differential temperature.

    An Infrared Thermography photograph of my house, from the outside, clearly shows the differential temperatures around windows and doors and voids in the insulation, but no moisture.

    Most moisture meters are designed to measure the moisture content of various species of wood. Keep in mind that virtually all building materials have a certain moisture content. Generally speaking the relative humidity in my house is about 50% with the HVA/C running.

    My moisture meter is completely useless for measuring the amount of moisture in drywall because I use a moisture meter in doing woodwork and my moisture meter is calibrated for southern yellow pine.

    "Prattling on and on about being an ass with experience doesn't make someone experienced. It just makes you an ass." Rod Buvens, Pilot grunt
    0
    Leland
    Advanced Member
    Advanced Member
    Posts:741


    --
    05/08/2011 3:02 AM
    Chuck, with all due respect, you are just using semantics. You could have been just as accurate to say that a moisture meter doesn't measure moisture- it measures electrical continuity (typically) which can be interpreted by an experienced user to determine moisture content.

    You wrote:

    Thermography does not detect moisture, Infrared Thermography measures temperature. Variances in temperature may indicate the presence of moisture. A Thermography photograph would show the pattern of differential temperature.

    Allow me to add a little something to the end of what you wrote:

    A Thermography photograph would show the pattern of differential temperature, which might reveal a pattern of moisture when there is one.

    I have seen a thermography machine used and it seemed pretty good to me at showing a very different color where water was thrown on a carpet. Granted, I knew it was water because I saw it thrown there as a test. But in a real situation I could imagine that if one spot on a ceiling was known to be wet (from touching it or testing with a moisture meter etc), and the thermography machine showed that specific spot and the area all around 12 feet in every direction to be the same color that would be a pretty good clue that there was a 24 ft diameter wet spot.

    If I was looking at the windows of your house I would know I was looking at the windows of your house. If the thermography camera was pointed at a hot exhaust pipe I would know that the color difference had nothing to do with moisture.

    But to be honest I have never paid anyone to use one of those machines so maybe I am totally wrong. In the scenario described about the EPDM roof if I knew there was a dispute about interior water intrusion being from a wind created opening or not I would just have the roofer do an interior inspection together with the roof inspection. That usually increases the cost of a professional roof inspection by $100.00 and its usually exactly what the carrier likes done.

    found on the web:
    ----------------------------------------------------------------------------------------------------------------------------------
    AMERICAN LEAK DETECTION EMPLOYS INFRARED THERMOGRAPHY TO DETECT WATER LEAKS

    Infrared Technology Eliminates Costly Destructive Probing Methods

    Dallas, Texas – American Leak Detection (http://www.alddfw.com), introduces Infrared Thermography as another piece of cutting edge technology that allows hidden water leaks to be detected. With Infrared Thermography, American Leak Detection can identify problem areas that can’t be seen by the naked eye - eliminating destructive probing methods. The infrared inspection can detect not only hidden water leaks and their origin, but also moisture that cannot be physically reached with moisture meters and even detects unseen pests.

    “The benefit to consumers is that we are able to see things the naked eye cannot, which eliminates the old methods of finding these types of leaks – such as cutting holes in walls, ceilings, and through floors. This of course, saves the home owner remodeling expenses.” says Will Knell, Director of Operations. “In the past, these hidden leaks often went undetected until they were very obvious, and therefore made repairs more costly”
    ------------------------------------------------------------------------------------------------------------------------------------------------------------
    RoofScanIR™ Service www.roofscanir.com [check out the photo on their website]

    During the day, the sun radiates energy onto the roof and into the roof substrate, and then at night, the roof radiates the heat back into outer space. This is called radiational cooling. Areas of the roof that are of a higher mass (wet) retain this heat longer than that of the lower mass (dry) areas. Infrared imagers can detect this heat and “see” the warmer, higher mass areas, during the “window” of uneven heat dissipation. Heat loss and other IR services can be performed at the same time.

    -----------------------------------------------------------------------------------------------------------------------------------------------
    http://www.oandsassociates.com/infr...raphy.html

    O&S Associates, Inc. is a diversified and multi-disciplined Consulting Engineering firm.

    Infrared and Roofing

    Infrared cameras enable roofing professionals to measure and compare the temperatures of roofing substrate materials that are wet—presumably from leaks, and roofing substrate that is dry. The dry roof areas cool faster after sunset and warm up faster than the wet areas after sunrise. This causes a temperature difference that can be imaged.

    The Practice is addressed by the American Society for Testing & Materials (ASTM) in measurement standard C1153, "Location of Wet Insulation in Roofing Systems Using Infrared Imaging."

    Water enters the roof system by means of splits, holes or faulty flashing, causing the roofing components (i.e. insulation, felts, decking) to become wet. The wetter areas store more heat from daytime solar loading and remain warmer at night. Reduced thermal value of water damaged insulation and/or decking materials also allows for heat transfer of interior energy through the wet components during the colder months. It is this thermal radiation of water present in the roof that the infrared camera records. The hot spots are visible on the surface of the roof when viewed through the infrared camera. Buildings with concrete decks rely mainly on solar loading to heat the roof system, therefore scanning concrete decked roof systems during the winter and roof sections that remain in shadow during the day (below units, overhangs, under gratings, etc.) provide negligible thermal profiles.

    Moisture entering the roof system at penetrations and base flashings that does not affect the insulation will not be detected by the infrared camera because the moisture can flow directly into the building interior, leaving the insulation unaffected. This can typically occur at pipe penetrations, pitch boxes, ventilators, mechanical units, skylights and masonry walls.

    The roof top is scanned during the evening- shortly after sundown in the winter, and one to two hours after sundown in the summer (these conditions may vary due to the type of roof membrane). Scanning at night allows for sufficient cooling of the roof surface and eliminates solar reflection resulting in a more accurate scan.

    The information can now be presented as colorized thermograms, with different colors or shades representing different surface temperatures. Variables that can affect the thermal radiation include wind velocity, cloud coverage, and material density. A color bar along the side of the thermograms indicates temperatures in ascending degrees with warmer areas at the right of the bar (typically the wettest areas in roofing and driest areas in the masonry scan). Corresponding visible light photographs help to orientate the thermograms, as well as give clues to water entry points.

    Why use Infrared Thermography on Flat Roofs? Infrared imaging is a proven method for identifying and defining moisture problems in your roof. This will enable you to develop a more sophisticated roof asset management program, make more informed decisions regarding roof budgets and will help you plan repairs.

    By using infrared thermography, we find the trapped moisture and mark the wet areas on the roof with marking paint, so that roof repairs can be
    made surgically - without the tremendous expense of replacing the entire roof.

    -------------------------------------------------------------------------------------------------------------

    and for something different, the Colombia Missouri utility gives free IR thermography inspections to find electrical HOT spots instead of moisture:

    How can an Infrared Thermography Inspection help?

    Columbia Water and Light business customers can receive a free infrared thermography inspection to find problematic equipment before it causes downtime. An infrared inspection can reveal hot spots in a number of areas:

    low voltage switch gear
    power distribution
    motor control centers
    control panels
    packaging/assembly lines
    distribution conveyers
    palletizers/unitizers/stretch wrap equipment
    facility wiring and breaker panels
    0
    Leland
    Advanced Member
    Advanced Member
    Posts:741


    --
    05/08/2011 3:07 AM
    this is the key sentence right here:

    The Practice is addressed by the American Society for Testing & Materials (ASTM) in measurement standard C1153, "Location of Wet Insulation in Roofing Systems Using Infrared Imaging."

    If ASTM says it works that's basically the final word.
    0
    Allfor1
    Guest
    Guest
    Posts:1


    --
    05/08/2011 11:47 PM
    I originally inspected this roof with the consultant hired by the insureds contractor and the insureds contractor. Of course they recommend a complete reroof. I have spoken to carrier and advised of said situation and also got permission to advise insured to file a sperate claim. Which is where the bulk of this dmg probably occurred. The consultant and the contractor want a new roof. Im not surprised to hear this. They have also been caught lying on several other properties owned by this insured that I have inspected with them. I have advised the consultant that asd opoint in the claim.we aren't recommending replacment and that they wil need to "prove" their claim. I expect an expert wil be acquired at some point. Once we receive that report we will progress accordingly. This set of consultant and contractor are really trying to inflate damages.
    I am awaiting their estimate to get an agreed score for the simple issues but s of today my multiple requests for, information have been met with excuse after excuse.
    This is not a TE payment situation. Professionally I feel compelled to handle this correctly but I don't want to work free either. I wil submit my recommendations including detailed accounts of all issues then I wil move on.
    A nyother advice wood be appreciatwd. I apologize for the sp and grammer using my phone to interact can be a challenge.
    T hanksto ask who answered.
    0
    Leland
    Advanced Member
    Advanced Member
    Posts:741


    --
    05/10/2011 1:54 AM
    Submit a question to the carrier regarding the "inconsistent" statements made on the other roofs. That will put those issues on record in the file. Don't use the word "lie".

    example:

    QUESTION SUBMITTED

    As the company is aware, the insured and his consultant have made numerous inconsistent and contradictory statements regarding other claims in the Smithville area. For example, on an unrelated claim for a building at 111 Maple St., the insured claimed the roof was only 1 year old when documents later showed it to be 7 years old. Please advise: Does the company advise the undersigned to take any additional steps to determine the accuracy of the insured's claims, such as contacting the building department or requesting a recorded interview?

    you wrote:

    I am awaiting their estimate to get an agreed score for the simple issues but as of today my multiple requests for, information have been met with excuse after excuse.

    Do you send letter so the insured, or only the carrier does that? Have you sent them a letter requesting an estimate?

    You can always send a letter requesting (demanding?) that they submit their estimate. You can also mention in your letter things that they said on the phone.

    example:

    Dear Mr. Insured

    As you are aware I am the independent adjuster assigned by Acme insurance to investigate your roof damage claim for your property at 111 Main St. Smithville USA. On April 2, 2011 I inspected the roof together with you and your contractor, Bubba Roofing. During the inspection I was informed by you that the roof was only 2 years old and was installed by Cadillac Roof Specialists at a cost of $567,000.00. Mr. Bubba indicated that the roof was made of high grade double spun gold and diamond woven fiber matting, installed by certified roof experts with construction PHDs. During the inspection you informed me that you would send me a copy of the original Acme invoice with a copy of your cancelled check. As of the date of this letter I have not received that documentation. Please submit that documentation as soon as possible in order that I may continue the adjustment of your claim. If that documentation is not available please advise me immediately.

    I also wish to draw your attention to the fact that based on our investigation the dimensions of your roof are 50' x 100', for a total of 5000 sq. ft. You will recall that Mr. Bubba indicated that the roof was over 6000 sq ft. If you have evidence to dispute our calculations, please provide it immediately.

    --------------------------------------------------------------------------------

    here's another idea/example:

    Let's say the insured has promised to send the estimate 3 different times in phone conversations. Assuming the carrier writes the letters, it might be a good idea for you to email the carrier and list the three dates you spoke to the insured and what was said. The carrier can use that information in their letter to the insured.

    ----------------------------------------------------------------------------

    My two cents regarding experts:

    Ask the company right away if they want one. Don't wait. Waiting is bad. Things change when you wait. Roofs get repaired when you wait. Evidence gets lost while you wait. Payments to the insured go out later when you wait. The insured (or their attorney) might decide to refuse access to the property while you wait. Maybe the carrier doesn't want an expert. Fine. But give them the opportunity to decide as as soon as possible.

    When you call the carrier explain to them why you think an expert would be a good idea. If you know the insured wants $50,000.00 more than what you think is reasonable, let the carrier know that. Ask the carrier for a name of an expert they like. Be prepared to give them one or two names of experts you know in case they don't know any already. Be prepared to give them an estimate of what the expert will charge.

    0
    Leland
    Advanced Member
    Advanced Member
    Posts:741


    --
    05/10/2011 2:01 AM
    Also, anytime you know that the insured is bringing an expert you should immediately notify the carrier and ask if they carrier would also like to send an expert.

    Example: the insured files a claim and says there is a small hole in the roof. You call the insured to schedule an inspection. He agrees to meet next Wednesday, and let's you know that his expert roofing consultant will be attending the inspection.

    In my opinion you should immediately call the carrier, let them know whats going on, and ask if they also want their expert to attend.

    They can also say no.

    But nobody can say you dropped the ball by not asking.
    0
    Ray Hall
    Senior Member
    Senior Member
    Posts:2443


    --
    05/17/2011 3:10 PM

     I disagree with Leelands post of May 10th. Just keep the inspection apt. and see what is involved and make a full report to the carrier. Two experts on a roof will not duke it and resove the claim. You have not waived any rights be "seeing and hearing the claims. Complex losses are never settled on a one shot basis.

    0
    You are not authorized to post a reply.


    These Forums are dedicated to discussion of Claims Adjusting.

    For the benefit of the community and to protect the integrity of the ecosystem, please observe the following posting guidelines: 
    • No Advertising. 
    • No vendor trolling / poaching. If someone posts about a vendor issue, allow the vendor or others to respond. Any post that looks like trolling / poaching will be removed.
    • No Flaming or Trolling.
    • No Profanity, Racism, or Prejudice.
    • Terms of Use Apply

      Site Moderators have the final word on approving / removing a thread or post or comment.