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CCarr

Canada
1200 Posts

Posted - 02/28/2004 :  11:20:28  Show Profile
It is not the place to debate it in this thread, but note Karen's perception as a consumer; that is the commentary of her last paragraph.

Unfortunately, that is not an uncommon perception by a consumer of property insurance.

"We" can not wash our hands of that negative perception, whether our income is derived from cat claims or day to day claims.

Her perception of the process plays right into the hand of the Bill Cook's of our industry, and rightfully so.
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Tuckernotis

USA
19 Posts

Posted - 02/28/2004 :  11:41:54  Show Profile
Follow-up. Just got back up on the roof for a more thorough look. We have holes clean through a lot of the shingles [Duh!]. Wonder how he missed that! Should we take preventive measures to ensure there is no more damage to the substrate? What can be done in the meanwhile?
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Johnd

USA
110 Posts

Posted - 02/28/2004 :  11:42:22  Show Profile
Karen Gray:
By the amount of help that you have received in the past 24 hours, you need to really re-think your statement about it being SOP to say no damage on first inspection. The majority (99%) of the adjusters that are on this site are HONORABLE and would NEVER participate in that kind of scenario.

As adjusters, we are OBLIGATED to do everything in our power to see that you receive EVERY dollar that is due you under your insurance contract. Who ever told you this is "pretty much SOP" is guilty of a gross fabrication. And for your information, we (adjusters) probably "dislike" car dealerships as much as you.

We wish you the best in obtaining a proper settlement on any damages you may have suffered. Please come back and let us know what the outcome was on your claim. WE CARE!

John Durham

EDIT:
Karen, read your policy! It states you must protect your property from further damage. Now, you must consider a contractor or roofer. This can be tricky as you must choose an honest one to represent you and cover any damaged areas of the roof. As Kile asked previously; "Who is your insurance carrier?"

John Durham
sui cuique fingunt fortunam

Edited by - Johnd on 02/28/2004 11:50:17
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Tuckernotis

USA
19 Posts

Posted - 02/28/2004 :  11:57:21  Show Profile
I didn't mean any disrespect to your profession. But having said that, I have spoken to no less than six other people who have had roof claims due to hail in the past and all of them had to go through the same thing. I'm not sure the "inspector" that came out was in your professional league so I wouldn't even make a comparison. Maybe it's just State Farm seeing that's who he works for. I don't know how anyone can say that it not a conflict of interest though if the adjuster or inspector is employed or paid by the insurer. I don't have any wish to get a new roof if it's not needed. It will raise my premiums and be a major inconvenience while being replaced not to mention the $1000 deductible. But I also want to make sure that I'm getting what I paid for, insurance against a loss. Maybe that debate is better left for another thread. I wasn't at all upset by the first pass from the inspector. It was completely expected. But I will get other opinions and not just from roofers since there is a conflict there too. I do have a friend that owns a roofing business but doesn't do residential work. He has the expertise to give me an unbiased opinion but has no commercial interest. Thanks for the input and please do not take it personally.
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Johnd

USA
110 Posts

Posted - 02/28/2004 :  12:11:48  Show Profile
Karen Gray:
Thank you for understanding where we are "coming from." As I stated earlier, please keep us informed because we really DO CARE that your experience ends on a positive note. As you are no douby aware, there are good and bad in every profession. We sincerely hope that your future encounters are only with the "good."

I sure hope that all who are reading this thread are also reading about the fee schedule discussion and the percieved (and actual) quality (and quantity) of adjusters as it relates to the schedule reductions. How many more insureds will have this perception of our ranks when the schedule is reduced to "burger flippin rates?" I hope all the Insurance Company Executives who are reading this thread can appreciate, and comprehend, the law of diminishing returns.

Professional CAT adjusters, DESERVE BETTER.

NOTE: This may be off topic, but I respectfully request this post be left here INTACT, as what better example could be presented regarding this subject.

John Durham
sui cuique fingunt fortunam
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KileAnderson

USA
875 Posts

Posted - 02/28/2004 :  16:37:48  Show Profile
Karen,

I have worked almost exclusively for State Farm as an independent adjuster over the last 5 years and I can tell you as a matter of fact that no State Farm adjuster has ever been told to deny a legitimate claim. As far as a conflict of interest, the only real person I believe that has a conflict of interst in the adjuster-homeowner-roofer triangle is the roofer. The roofer is the only one that stands to make any money off of this deal, the adjuster gets to do the work, the insured has to pay his deductible but the roofer makes a sale and puts money in his pocket. The adjuster for the most part gets paid the same no matter if he pays for the roof or not.

The adjuster wants to make the right call because if he denies a valid claim he will probably have to go back out and reinspect it and when you already have dozens or even more than a hundred claims to worry about the last thing you need to be doing is reinspecting. It is a big waste of time to say no and have to drive all the way out there again to reinspect(I'm sure the closest claims office is an hours drive from Des Almends). Do you have any idea of the age or experience of the adjuster who looked at your roof? I've been doing this for 5 years and I live in Baton Rouge and I have never worked a hail claim in Louisiana. We just don't get that much hail. Maybe he was inexperienced. Did he pay you for the patio cover? Did he mention seeing any damage at all?

I understand your distrust of adjusters and big insurance companies, it does seem that they are holding all the cards and you are just one person against a big corporation, but keep in mind that the reason that corporation is so big is because they serve their customers. If they made a practice of bad faith claim handling they wouldn't be in business any more. Also, just to let you know, from personal experience, I've never met a roofer that didn't think a roof had hail damage. I have heard from some insured's about them, but I've never actually met one.

If you have a hard time getting a reinspection ask to speak to his supervisor and send them some pictures of the hail damage.

Edited by - KileAnderson on 02/28/2004 16:43:21
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william s cook

53 Posts

Posted - 02/28/2004 :  19:21:40  Show Profile

Dear Clayton,
This appears to be a walk in the park for a PA to get Karen paid her entitlements if the circumstances are found to be as described by Karen. Unfortunatly for Karen, she appears to have drawn an adjuster that has poor vision. Unfortunatly for Karen and her six neigbors, they now have an uphill battle to cause insurers to reverse their decisions of denial based on the written report based on a nearsighted adjuster's failure to see the reportedly obvious damages. Unfortunatly for Karen, she may be forced to seek an attorney to enforce the contract terms of entitlements. Unfortunatly for Karen, most attorneys will not take a small property damage case on a continegency fee basis. Unfortunatly for most insureds, they lack the financial resources to to fund an attorney on an hourly basis against a first party carrier. Unfortunatly for Karen, anyone other than a licensed attorney can not advance her cause or give advices on contracts that impact legal rights in Lousiana. Unfortunatly for Karen, she must acquire the knowledge to level the playing field with insurers while maintaining her normal duties and lifestyle. Karen can retain and pay a non-reimbursable fee for a consulting engineer's report to substantiate her claim with insurers. Karen can demand an appraisal but unfortunatly for her she will be liable for the apprasiers fees as well as one half of the expenses of the umpire. Unfortunatly for Karen she must mitigate her damages while preserving the damages for inspection by the appraisal forum. I would volunteer my assistance but unfortunatly for Karen Lousiana has stiff fines and punishment in the UPL regulations. Sorry Clayton, my hands are tied in this instance. Karen may get lucky on her draw for a re-inspection and none of this unfortunate described scenario will apply.
William S. "Bill" Cook
Public Adjuster in seven other states
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KileAnderson

USA
875 Posts

Posted - 02/28/2004 :  19:34:21  Show Profile
Mr. Cook, has it even crossed you mind that their may not be any damages at all? I'm not saying that Karen is wrong, but you have automatically assumed that she has damage. It is possible that there is no damage and what Karen and her neighbors are calling hail damage is something other than hail damage. Karen also said that her roof was 9 years old. I know that we have had some tropical visitors in Louisiana in the last 9 years, Isadore and Lili just over a year ago. Maybe the roofs of her and her neighbors were paid for from those storms and never replaced. I'm not saying that I know any of this, but I also can't rule it out because I don't have access to her claim history.

Once again, I'm not saying the adjuster is right and Karen is wrong, I'm just saying that none of us here have the full picture, just the parts of the picture that Karen is giving us.

Karen, please fill us in on this issue, have you had a roof claim before? If so did you replace the roof that you were paid for? I'm not accusing you of anything, just trying to make some sense out of the situation you are in.

Edited by - KileAnderson on 02/28/2004 21:06:34
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KileAnderson

USA
875 Posts

Posted - 02/28/2004 :  19:54:06  Show Profile

I tried to upload an image but it didn't work.

Edit by admin, to upload photos use the paper clip icon found below the message box. The image icon is for an images already on the web. Roy

Edited by - KileAnderson on 02/28/2004 19:57:58
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Tuckernotis

USA
19 Posts

Posted - 02/28/2004 :  20:43:23  Show Profile
Ok, maybe this will work. I've loaded all the pictures into Webshots. Hope the links work. Some of the pictures of the actual hailstorm are dark because it happened right at dawn, 6:15 am. I don't have photos of the holes yet. Will try to get those tomorrow and load them up.

http://community.webshots.com/album/121821794DfGyzh


BTW, the six people I was referring to weren't neighbors. They were co-workers and relatives that all live in different areas and were referring to different incidents. The surrounding neighbors all said nothing like this has ever happened here. My home is 9 yo and the roof is original. The neighbor to one side (the one with the bump on the head) has been here for 20 years. Granted, we have been visited by two tropical events in the last two years. None of which had winds greater than tropical storm strength. A good Nor'Easter has worse. To answer a question about the patio roof, yes, he said that was a total loss. I actually disagree. It is dinged up but appears cosmetic. There are no punctures and it is insulated (actually a sunroom). I don't want a new roof on it. Figures.
I have learned a lot from this forum especially about the relationship of the adjuster and insurer. Also about what to look for since I'm not a roofer. I believe in being an informed consumer. Thanks to everyone for their help and concern. I'm sure everything will be worked out to an equitable resolution.
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KileAnderson

USA
875 Posts

Posted - 02/28/2004 :  21:21:40  Show Profile
Karen, those are very interesting pictures. I noticed you said that you believe that the damage to your patio roof was only cosmetic. In actuality fresh hail damage is mostly cosmetic. But this damage can accelerate the deterioration of the material and early failure. If I were you I would wait until you get the estimate from the adjuster. He may have gotten back to the office and shown the pictures to someone and they advised him to pay for the roof. Once you get you estimate, if he has not paid for the roof and you firmly believe that your roof is damaged, have a roofer inspect your roof and right an estimate for it's replacement. Make sure that he indicates on the estimate that it needs to be replaced due to hail damage. Then take this estimate down to your agents office and have him fax it to the adjuster. The adjuster should contact you and the roofer and set up an appointment to meet with the roofer and reinspect your roof. The roofer will be able to point out what he believes is damage and the adjuster can give his opinion on whether it is or is not damage. If it is hail damage I'm sure the adjuster will make good on your claim. Just be patient. No one is trying to deny you what is rightfully owed. Everyone makes mistakes.

Just a little word of advise. Be patient and polite at all times. I probably don't have to tell you this but it is alot easier to catch flies with honey than vinegar. Be patient, be polite and if you are not happy with the results of the reinspection get your agent involved. He wants you to be happy.
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william s cook

53 Posts

Posted - 02/29/2004 :  08:25:49  Show Profile
The majority of my claims history has not been in handling hail losses. Accordingly I yield to the experts, I will sit down and shut up.
William S Cook
Public Adjuster

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katadj

USA
315 Posts

Posted - 02/29/2004 :  09:20:18  Show Profile

Well, perhaps some can remember Jan, 2000 in New Orleans when a freak storm damaged almost all of the French Quarter and out as far as Kenner.

I have been involved in appraisals there since the event and am STILL working files there in excess of $10,000,000.00.

SO, Louisiana does get hail, not often, but it does happen.

Karen, from a cursory review of your photographs, and in agreement with Kile, you do have substantial damages, which you may be entitled to be compensated for, and the Insurance contract is one of adhesion and indemnity.



Protect your assets with tarps or poly.

A PA is allowed in LA, but only on an hourly wage basis, not on a contingent fee basis, at the present time, although this is being litigated.

Maybe the squeaky wheel will get the grease, nice is nice, and Wrong is wrong.

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KileAnderson

USA
875 Posts

Posted - 02/29/2004 :  09:54:54  Show Profile
Mr. Hood,

I am very much aware of the January 2000 hail storm in New Orleans. I'm also very aware of the 2001 storm in Alexandria as well as the one in 2003. There have also been several in Shreveport and Monroe. My point was that in south Louisiana hail is very rare. I didn't say it doesn't happen. I was just pointing out that staff adjusters in south LA will have significantly less experience with hail damage than say adjusters in Dallas or Omaha or OKC.
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trader

USA
236 Posts

Posted - 02/29/2004 :  14:16:21  Show Profile
Adjusters have two worst nightmares:
1. To recommend a payment that is not owed; BUT a far greater fear is to NOT to recommend a payment that is owed.
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