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Mike, actually I under exaggerated. For instance I have a claim right now. One damaged marble tile, easy $10.00 repair. We have sent out a flooring expert and an engineer. Both say the tile is no longer available for a matching repair. The insured does not have any stored extra tiles. Approximately 2500sf of this continuous tile plus matching baseboard. All kitchen cabinets and bathroom vanities are installed over the tile. The insured will not agree to a harvest from say the laundry room or from underneath an appliance. The insured will not agree to different tile in the effected room with a transitional decorative threshhold between the adjoining rooms. This claim will require all tile be removed, all base removed, all cabinets and vanities reset, long term storage of contents, minimum two weeks hotel ALE, tile and base replaced, walls painted etc etc etc. The estimate is already approaching $130,000.00. And even this estimate is on the lowball side. If the granite countertops and backsplash of the cabinets and vanities crack during resetting we will be on the hook for that as well. Got to love south Florida, public adjusters and contractors. Bob what percentage of your claims are represented either by a PA or contractor? I have heard CA and NY are very similar to south Florida.

Posted By Wes Davis on 18 Nov 2008 12:44 AM 
... Bob what percentage of your claims are represented either by a PA or contractor? I have heard CA and NY are very similar to south Florida.

"one chipped $3.00 tile and we are paying for a $50K remodel"......A little bit of exaggeration I hope? 

Show me a loss with 1 single tile damaged that results in an entire floor being replaced, and I will show you a lazy claim manager afraid of fighting the battle.  Show me the entitled homeowner that doesn't want to "harvest" a tile from under the fridge or stove or pantry, and I'll show you the way to arbitration.  Show me a staff adjuster that thinks replacing the whole floor is correct, and I'll show you an unemployed staff adjuster.  Show me an IA with the same thoughts, and I'll show you someone only interested in the fee schedule.  Show me a jury of your peers if it comes down to that, and I'll show you a homeowner that never intended on replacing the floor.  And, I'm not even from Missouri!  Do you really really believe that a replica tile cannot be produced if not already available somewhere?  We landed on the moon how long ago?

Mike you basically just described every single claim I handle. LOL We do occasionally try to go a repair route but every one of these claims ends up in appraisal or mediation. The insured is owed to be made whole and thats how it always ends up. When you go to mediation or appraisal the assigned officiator is going to look at it just like it was there own home and insurance claim. Do you think the officiator would settle for having tiles broken up from one part of the house to be used in another or a newly purchased tile that is clearly not going to match the existing tiles that have already been in place for one year with normal color fade. These are south Florida homes site built or newly remodeled and when a homeowner says they want continuous travertine or marble throughout at a cost of $25,000.00 they are proud of their home. It is something to invite the neighbors over to see and gloat over. They are not now going to settle for a home with patch work tile flooring no matter what caused the damage even when its their fault because they dropped a frying pan in the kitchen. This is what they pay unbelievably high insurance premiums for. South Florida is a different world guys when it comes to claims handling. These aren't farm houses with linoleum in the kitchen, laminate in the living room, shag in the den and green carpet in the bedrooms.

P.S. where would you like me to send you copies of my single tile claims? I have a few hundred for your review. LOL

Show me a jury of your peers if it comes down to that, and I'll show you a homeowner that never intended on replacing the floor.

It is truly a unique situation in Florida and a few other parts of the country. I am originally from West Virginia. I was back there a few years ago and a relatives home flooded with sewage. I did everything I could to convince them to call their insurance company and a mitigation company. They would not even consider it. To them this was just an unfortunate incident requiring a little cleanup. Insurance in their minds appears to be only used in case your house burns to the ground.

The arbitration environment in Florida is unreal. I know this from experience. And, yes, that is part of the reason for very high premiums in Florida and why some companies have abandoned the Florida market.

Several years ago I was working claims in Brooklyn and the Bronx, the company had a survey that said that a $10,000.00 claim in Oklahoma would be a $1,000,000 claim in the Bronx.  Liability claims, but it points out the difference in claims awareness.

These type losses are the ones that the word "indemnity" in the "London" sense of the word is most meaningful. In the international insurance world it means...." the repairs have been made that cost XXXX and I am asking for indemniity, as this is what I have spent...... try using the true meaning of indemnity. 

Chuck,

I had a frank discussion with a contractor in Scarsdale (10 miles north of the Bronx) in 2004. He admitted that his estimate was three times the cost of repairs. He told me the reason for that was that this woman (the insured) would make him redo the job twice, even if it is perfect the first time, "just on the principal of it". I knew he was right, so I did what I could for him. That's pretty much standard practice there. All the contractor estimates in that area were three times the cost of repairs, so it meant a lot of wrangling over pricing. The Simsol pricing module I was using for the Bronx, if I remember correctly, used a factor of 134% of national average pricing to adjust for local differences.

I think the insurance commision of the state of Florida should investigate some of the claims that are paid by insurance carriers that are licensed to do business in Florida if some of the losses Wes Davis works are paid. If this practice of accepting the agrument that the toe bone is connected to all the other bones in a human body is the norm to pay these type presented claim the carrier should loose their license in Floridia. Its an insurance crisis in Florida and if what Wes describes is going on its criminal negligence on the part of all the actors. Insane I can not believe what I read.

Posted By Ray Hall on 20 Nov 2008 09:40 PM
I think the insurance commision of the state of Florida should investigate some of the claims that are paid by insurance carriers that are licensed to do business in Florida if some of the losses Wes Davis works are paid. If this practice of accepting the agrument that the toe bone is connected to all the other bones in a human body is the norm to pay these type presented claims the carrier should loose their license in Floridia. Its an insurance crisis in Florida and if what Wes describes is going on its criminal negligence on the part of all the actors. Insane I can not believe what I read.

In 2000 I saw the mold fraud ruin the rates in the state of Texas for ever person that had to purchase Homeowners Insurance by 300 %. The carriers jumped through the fire to pay billions to the water suckers, and all the mold experts that came out of the three year nightmare of insanity when they told people to THROW any item made of fabric away. BUT MOVE OUT INTO AN APARTMENT and burn up all the ALE coverage. A hoax.

About 200 insurance carriers paid and raised the rates 300% and still raise ever year. Is that protection ??? . Do you ever get the feeling that 5% of a trillion is better than 5% of a billion. Insanity.

Ray, I tried my abacus and it didn't have enough splines & discs, and then tried my calculator and it wouldn't hold that many zeros.  But I think you're right.  It all adds up to insanity.  If you are willing to accept insanity, and continue to elect the officials that promote or accept insanity while they appoint the insanity police, one has to question your own sanity. Where's the control?  The current generation of adjusters and claims management has early osteoporosis and the backbone is eroding.

I thought we (Florida) would switch to the same type of Texas insurance coverage a few years ago but it hasn't happened yet. I am telling you guys its crazy and I have in part watched it evolve. The carriers used to fight these types of tile claims, kitchen cabinet claims and mold claims but they lost every single battle in court so they are barely even questioned anymore. Especially if you can provide any documentation at all from a so called 'expert'. The only thing that has changed is the new $10,000.00 mold limit that went into effect about three years ago.