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trader
USA
236 Posts |
 Posted - 12/05/2003 : 22:03:06
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| REPLACEMENT COST COVERAGE ...is the language that is most abused in the contract... by both sides. The intent and definition is: the depreciation (betterment) is recoverable when the work is completed and the proceeds have been spent. |
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Newt
USA
657 Posts |
Posted - 12/09/2003 : 09:18:06
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I had a good one, photos clearly showed a repair from a previous claim, which the insured was paid for a replacement. The miss-match stood out. An add-on room on the rear of the house had less than a 1:12 pitch with only a normal overlap on the 20yr shingles..no waterguard noted, resulting in water damage to the rooms ceiling.
Being new, I adjusted the claim and informed the carrier of my findings. My photos showed actual wind damage, however, the owe to match and the risk of the flat roof will be up to them as it should be.
I only report things as I see them and provide documentation to back up the claim.
By the way, only one trapazoid slope was damaged and of course the add-on room, which I suggested paying. (less than $1200 after deductable)
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C Bond
32 Posts |
Posted - 12/13/2003 : 12:58:43
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While the carriers don't owe to match its been my experience that the amount of addition money to match and the preceived stubborness of the insured are the determining factors which the carrier truly considers. The story goes like this: 1) the initial adjuster provides for repairs without match. 2) The insured contests the scope and estimate, usually by employing a P.A. and 3) A reinspect and negotiation is preformed by a second adjuster causing the first to lose his holdback. Invariably the carrier settles for a reduction of the P.A.'s estimate and the insured gets their match.
If matching is such a definate no pay, then why are so many carriers paying when this is contested by the insured. I have assumed that the additional time and expense to the carrier is not worth the cost to match in these cases. (the matching cost in most of the files I have in mind were less than $3000)
This position on the carrier's part makes it very difficult if not impossible to accurately adjust a claim according to the policy and keep your files closed at the same time. Do you all agree or have I missed something here? Comments Please |
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Roof_Dr_Sr
USA
27 Posts |
Posted - 03/10/2004 : 06:36:00
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From my experience I have found most companies don't care if the color matches or not. In fact, I am going to go look at a home today that is 2 story 14/12 pitch that is comp over wood shingles. The adjuster told me yesterday that he doesn't care if the color is even close. He said his policy doesn't cover matching color. Another-words, I could put red on a brown roof and he says that's ok. It may be ok with him and his company but I believe we all need to do what is right for the homeowner. After all, they look to the adjusters as someone who cares about them and their problem. I have always found that the adjusters who really care will solve the problem before they leave the site.
As a roofing contractor, I have a real problem with 1/2 roofs, one slope here and their. It's very difficult to repair one side of the roof without doing damage to the other side while roofing. (especially during 100 degree days in Texas) Try doing a 1/2 roof of class 4 modified from Atlas or other manufactures. You will be doing something in the wind! Don't stand too close. Our company refuses to do 1/2 roofing jobs. The liability is too great as far as what happens if it leaks. The homeowner is going to call you out no matter what side is leaking. If it is the side that you did not, and then who pays for the tech that was sent out? In our case we would bill the customer for a trip charge then everyone gets mad. Of course all homeowners think we should work for free anyway, along with many insurance companies. Had an insurance company yesterday tell their client to call out a roofing contractor because their fen SE was blown down. The contractor will inspect the roof for free to see if they have any damage. Perfect example. I believe the insurance company owes to replace the entire roof when a portion gets damaged unless it's something like a small hole from a limb or something like that. After all, the homeowner pays a full amount each month for coverage don't they?
Taking cover and awaiting your replys, The Roof Dr.Sr.
Roof Dr.Sr.
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Roof Dr.Sr. |
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KileAnderson
USA
875 Posts |
Posted - 03/10/2004 : 19:00:41
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| They pay for coverage for direct physical damage. If the front slope is damaged by wind and the back slope isn't they are not owed for both. If your left fender is dented do you expect to get your right fender replaced? It doesn't work that way, Hoss. |
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JimF
USA
1014 Posts |
Posted - 03/10/2004 : 19:43:40
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Kile. Really now.
Do you honestly expect everyone around here to pick up an insurance policy and actually read the damn thing?
Especially when Ghostbuster is passing out old issues from his childhood National Geographic collection for free after the wife made him clean out the attic or else? |
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Ghostbuster
476 Posts |
Posted - 03/10/2004 : 22:19:49
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| That's right, Kile. It's the same thing as when Jimf was cleaning out his collection of Playboy magazines and singing, 'Thanks for the mammeries!' |
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alanporco
USA
112 Posts |
Posted - 03/10/2004 : 22:36:09
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Roof Dr Sr,
Your last post is typical of roofer's attitude toward repair work. They don't like it, they would rather replace the entire roof (more money; i.e., profit and probably easier to do). The problem for an adjuster arises when the insured has been told by a roofer that the roof is damaged and needs to be replaced. While it may true that the entire roof needs to be replaced, is it due to covered damage or due to age, wear & tear? The only thing the home owner hears is "damage" and "replacement." As to whether or not the entire roof gets replaced, this usually depends on how loud the insured grumbles to somebody above the adjuster. |
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Steve H
Switzerland
30 Posts |
Posted - 03/12/2004 : 00:24:31
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| If you're in CA, you may owe to match on the side(s) that are visible from the street, courtesy of the Ins Commisioner. So I have been told. |
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Catmandale
USA
67 Posts |
Posted - 03/12/2004 : 00:59:49
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Steve,
To expand on what you said, I recall that the CA guidelines changed from "line of sight from the area of damage"...to the current measure of "reasonably uniform appearance", without a caveat regarding the point of reference (...from the area of damage)
In practice, if you have damage only to the front slope of a straight gable, you might do just the front slope to the ridge cap. If you had a front slope damage with a hip, and you can see that adjacent slope, it goes too, up to a ridge cap line.
Dale |
Edited by - Catmandale on 03/12/2004 01:04:24 |
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KileAnderson
USA
875 Posts |
Posted - 03/12/2004 : 18:25:42
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| Dale, that seems like a very slippery slope (pun intended). If you replace the adjoining hip, then that hip doesn't match the back, then that slope doesn't match the adjoining extension. It seeems that on a hip roof if you replace one slope then by this standard you will be doing the whole house. |
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Linda
USA
127 Posts |
Posted - 03/12/2004 : 23:07:29
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It has been my experience that "line of sight" is considered in a partial loss. If you can see it--you replace it. A hip roof is normally replaced/repaired entirely. There are the exceptions. Some carriers take this into consideration and some do not. If it is a gable roof, you replace the ridge as well. I am not sure we as adjusters can do more than recommend what we perceive to be the proper repair/replacement. The carrier has the last say regardless of what we personally have estimated.
I think we need a new thread regarding charge back of fees. This seems to be happening with more frequency. |
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Catmandale
USA
67 Posts |
Posted - 03/13/2004 : 13:47:01
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Kile,
The previous standard (California only, as far as I know) was to pay for areas visible when you stand at the area of damage, whereas the new standard does not go beyond "reasonably uniform appearance." The new standard seems to have a greater opportunity for individual interpretation.
Using the old standard, if you could not see the slope from the area of damage, it was not included, even though it adjoined a slope paid for because it could be seen from an area that was contiguous and viewable from the damaged area (although entire slopes rather than portions were figure.)
This seemed to be more of an issue with wind damage, as hail is not that prevalent in sunny CA.
Where to stop is very seldom an easy call.
Availability of materials is a factor too.
What constitutes a reasonably uniform appearance? The same shingle and color in a different run or batch? Variegated shingle colorations can be easier to achieve a range of matching.
Companies varied in their interpretation of both "rules".
This standard was not limited to roofs, but included carpet and other items. |
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Roof_Dr_Sr
USA
27 Posts |
Posted - 03/22/2004 : 06:35:10
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quote:
Originally posted by alanporco
Roof Dr Sr,
Your last post is typical of roofer's attitude toward repair work. They don't like it, they would rather replace the entire roof (more money; i.e., profit and probably easier to do). The problem for an adjuster arises when the insured has been told by a roofer that the roof is damaged and needs to be replaced. While it may true that the entire roof needs to be replaced, is it due to covered damage or due to age, wear & tear? The only thing the home owner hears is "damage" and "replacement." As to whether or not the entire roof gets replaced, this usually depends on how loud the insured grumbles to somebody above the adjuster.
If I'm not mistaken that is called "The squeeky wheel gets oil first". However you are definatelly wrong about one thing, I would much rather repair a roof than replace it. I make a heck of a lot more money on repairs (based upon what insurance companies pay to have roofs done in Texas)than I do on re-roofs. On repairs we don't have an insurance company adjuster telling us how much money we can charge to keep our company running. |
Roof Dr.Sr. |
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alanporco
USA
112 Posts |
Posted - 03/22/2004 : 11:04:33
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| Ditto my reply in the other form. |
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hail claim for damage to portion of HO roof
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