Playing the Insurance Commissioner Card How to Deal With Stonewalling
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
www.roofsalesmastery.com
Playing the Insurance Commissioner Card How to Deal With Stonewalling For the majority of your claims and supplements, you will be able to have a productive correspondence with a desk adjuster who may not give you everything on your wish list, but is fair and meets in the middle to ensure you both make a just compromise. Every now and again though, you’re bound to run into an adjuster or insurance carrier who not only refuses to requests, reasons, and pursuit of a discussion to work on the claim go unanswered, unresolved, and blatantly ignored for days, weeks, even months. What do you do? This is where I like to use the insurance commissioner “card.” I’ve only ever had to use it three times so far, but it worked like a charm each of those times. In fact, only 1 time did I ever actually have to follow through and truly contact the insurance commissioner. The other two instances I just had to bring up that I would. Each state has an insurance commissioner who essentially behaves as a referee between insurance carriers and insureds, and is really there to be the policyholder’s advocate. They monitor what the insurance companies are doing and deal with complaints or unfair settlements when they are reported by homeowners. In this section I will walk you through 3 circumstances where I had to involve or threaten to involve the insurance commissioner that worked to get the insurance company’s attention so we could settle the claim in a becomes necessary to use the commissioner as a tactic to make progress with a claim. 1. Greenawalt. In this claim, the estimate was just really low and inaccurate. I was present for the adjuster meeting, and to my understanding the adjuster and I were on the same page. He even took a copy of my Xactimate estimate and diagram. When his assessment came back, there were a ton of mistakes throughout. In addition, the shed roof which was the same age as the house roof (if not older) was not included in the scope, even though it was within six feet of the house and had just as much damage on it as the house roof. I had sent my supplement by email, fax, and phone literally hundreds of times with absolutely no response, for months. The insurance company and the claims handler refused to acknowledge it or respond to myself nor the policyholder. It was ridiculous. One day, I sat at the fax machine and repeatguage in the email I was getting pretty aggravated and furious. Under normal circumstances, I would never approach a claim this way. However, we were being completely stonewalled. At this point I was is in claims. Finally, I sent my insurance commissioner involvement intent message. Within hours, we had not only a response, but our supplement completely approved. See the process over the next few pages:
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
www.roofsalesmastery.com
1
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
Within just a couple of hours, we had a response, and we got it settled:
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
2. Hutchins. This was a claim where the adjuster who visited the property was making excuses not to replace things that were completely invalid. For example, he claimed that the gutters (which were clearly dented from the hail as you can see by the photos) couldn’t be covered because it the damage was “cosmetic.” I said, “So….doesn’t your insurance company pay for hail damage on cars?” to which he replied, “Oh yeah, we’ve had a lot of those claims from this same storm.” So I said, “Okay…so how does that work out…isn’t that damage also only cosmetic? I’ve never heard of this rule on gutters before.” He shrugged and responded, “Those are the rules,” and left it at that. Obviously this wasn’t true. This adjuster was either just wrong, inexperienced, or lying. There were several items on the claim that should have been included and covered, so when the estimate came back, we sent off a supplement. ….like 50 times. Same issue. No one was responding. We left messages, sent the email repeatedly, faxed it – no response, period. Cue insurance commissioner play. We got a phone call the very next day, and our complete estimate including all the supplemental items was approved. Review the process over the next few pages:
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
www.roofsalesmastery.com
2
Original supplement request sent:
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
Notes: See that we got my full estimate/supplement approved through this avenue, and the actual correspondence between the adjuster and I remained cordial (despite being left with no other option than to threaten to involve the commissioner) and it ended with him thanking me for my assistance in the claim.
I easily got the gutters through with the desk adjuster using fairness, reasoning, and photographic evidence along with my straight forward Xactimate estimate/supplement.
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
3. Liley. tion, took my estimate, and went to the front door to recap with the homeowner what he had decided
-
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
www.roofsalesmastery.com
3
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
Alison Liley 3520 St. Francis Drive Arnold, MO 63010 October 31, 2013 To whom it may concern, My name is Alison Liley, and I carry Allstate property insurance. I have a 23-24 year old roof on my house that sustained damages from both wind (multiple missing shingles from a storm on May 31, 2013) and hail damage (one of the largest storms being March 28, 2012 hitting the St. Louis metropolitan area). I had a contractor (ReAllstate sent out an adjuster who met with my contractor and assessed my property and then came to the front door to explain what they would be covering, which was to be full replacement of my roof (as there were both missing shingles from wind and hail bruising, and additionally the age and condition of the shingles would ries, gutter replacement (the gutters sustained dents from the hail as well), and repair of a fence that had blown over in my back yard. October 16, I received an estimate from Allstate itemizing the above line items to be replaced, including a summary of the settlement and an ACV check in the amount of $2,227.36 (see attached). Then, something strange happened. I received a call from Allstate on October 21, saying they were “reversing” my assessment and taking back their estimate. They told me not to cash my check. They were not paying for the full replacement of my roof, but now deciding only to pay for certain shingles to be replaced. As you can imagine, as a policyholder I am extremely upset, confused, and angry. I do not believe it is fair or just to provide a homeowner with an assessment AND a check, send them on their way to begin facilitating the
then received a call from Allstate attempting to negotiate that we “wipe the slate clean and do a re-inspection.” This suggestion does not satisfy me nor does it seem fair or right. I feel that no institution should be allowed to give an assessment, make a payment, and then change their mind on a whim. What I want is what I was originally promised and estimated (which is attached): full replacement of my roof for the full RCV of $6,336.81. I am fully prepared to employ legal assistance on my behalf if this matter is not settled to my satisfaction – all I want is what is fair and what was promised to me from the start. I look forward to hearing from you and receiving some assistance on this matter. Regards, Alison Liley
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
That concludes the 3 unusual circumstances where normal negotiating tactics were useless in seeking to gain proper coverage for hail claims. To summarize, the point is not to be the boy who cries wolf and use this strategy every time you don’t get ridge and starter; this is reserved for the rare circumstances that the insurance company is blatantly refusing to even discuss matters with you.
(c) Copyright 2013 - Roof Sales Mastery, LLC - All Rights Reserved
www.roofsalesmastery.com
4