Claims History and New Homeowners' Application

[VolAgent]

Why is he sleazy? Wouldn't a claims adjuster confirm the damage before paying out a claim?

Just curious.

Seems to me, as a L&H guy, that P&C agents hate claims because it affects their bonuses. To draw an analogy, would we call a Doctor sleazy for telling someone to make a medical claim for cancer treatments? Same thing, you typically don't know you have cancer until a doctor tells you that you have it.

I get a mailer once a week telling me that there was hail and I need to get a new roof.

This completely ignores two important facts.

1. I had the roof replaced less than two months ago.
2. I cannot remember the last time it hailed here (think years).

Oh, and roofing contractors have to be the sleaziest. How many people will actually get up on the roof to inspect the work?

The house is over 100 years old. They found spots with 4 or more layers of roofing. They found shingles that haven't been made since the 20s as well as wooden shingles in other spots.

My handyman came by during it all and told me it is common for roofers to rip up a few feet from the edge and then just put it over the existing roofing. Most people just check the edge, see two shingles and say there is only one layer. The reason they see two is that you have to put an extra shingle on the bottom, but turn it over because of how they are designed to go over half the previous shingle.

 

[Accelerated]

You can pay the premium or you can own the loss.

2nd Best signature on the forum.

 

[VolAgent]

Best signature on the forum.

I wish I could claim credit. It goes to one of the ONFS guys. They were talking about their DI during the PPGA orientation. I thought it described insurance perfectly.

So now you changed it to say second best. Whose is better?

 

[Accelerated]

So now you changed it to say second best. Whose is better?

Mine. If you add my company name to yours, it would be the best.

 

[VolAgent]

Mine. If you add my company name to yours, it would be the best.

While I'm not cheap, I can be bought.

 

[sshafran]

Some are sleazy, some are not. Fact is, roofing contractors have a tendency to canvass a neighborhood telling everyone in the neighborhood that they have hail damage. Some contractors follow the published hail tracks, only hitting areas that did in fact have reported hail large enough to cause damage. Many contractors simply send inexperienced sales forces into any neighborhood, and neither of the two has a stellar track record when it comes to actually performing a roof inspection prior to convincing the insured to file a hail claim.

Your analogy might be more accurate if a doctor was telling every patient to file a claim for cancer treatments prior to examining the patients.

With regards to an adjuster confirming damages prior to paying a claim, most of the time, this is accurate (some carriers are handling small claims from the desk, and probably paying out on claims that they should not be), but it still costs the carrier money, and that cost is passed on to the consumer via premiums. Whether they salary staff adjusters and provide them company software, vehicles, fuel, benefits, pay for matching SS, medicare, workmans comp, payroll tax, etc, or they hire an independent adjusting firm like ours, the cost of handling frivolous claims caused by contractor canvassing is astronomical.

Even during the busiest of seasons, a minimum of 10-15% of hail claims are claims in which there is zero damage. Many times, the insureds themselves are aware of this, but "feels like having someone check it out is the prudent thing to do, since the contractor said...". A shocking number of insured's state something to the effect of "We didn't even know it hailed here, but the contractor said...". The follow up question reveals even more about this harsh reality: "Did the contractor actually get on the roof and inspect it?". What percentage do you think answers in the affirmative? (Spoiler: Almost none).

So yes, there are a lot of good contractors out there, and there are a lot of "sleazy" contractors out there, too. A contractor that makes a declarative statement regarding damages and advises a homeowner as to actions that should be taken that could result in the raising of policy premiums to the homeowner and causing additional cost to a third party (the carrier), without taking the time to actually perform an inspection and confirm the presence of physical damage would indeed fit the definition of "sleazy".

Well, if a contractor doesn't actually do his job and inspect, then of course he is sleazy. You'd have to be a pretty naive person to file a claim based on what your contractor said when he didn't even look at the roof and take pictures...

My beef was about the blanket statement. Seems like the guy did his job and the claims adjuster confirmed he was right. Nothing sleazy about that. And if we have a problem with the fact that he went door to door looking for work then we should delete this thread...

I once called in to make a claim and the agent tried to talk me out of it (as if she knew better). Seemed like she was more concerned about her bottom line. I wonder how many sleazy agent/adjusters there are out there who prevent/deny valid claims. If 10-15%, then I guess the world is even...

 

[benwrigh]

Well, if a contractor doesn't actually do his job and inspect, then of course he is sleazy. You'd have to be a pretty naive person to file a claim based on what your contractor said when he didn't even look at the roof and take pictures...

My beef was about the blanket statement. Seems like the guy did his job and the claims adjuster confirmed he was right. Nothing sleazy about that. And if we have a problem with the fact that he went door to door looking for work then we should delete this thread...

I once called in to make a claim and the agent tried to talk me out of it (as if she knew better). Seemed like she was more concerned about her bottom line. I wonder how many sleazy agent/adjusters there are out there who prevent/deny valid claims. If 10-15%, then I guess the world is even...

Obviously I don't know if your agent was trying to protect her bottom line, but there have been many cases where I have advised a client not to turn in a perfectly valid claim. It has never been because I was trying to protect myself.

I don't think anyone is saying that all contractors are sleazy, just that we see too many who are doing things the wrong way. They are not all Mike Holmes.

 

[djs]

My comment was based on the OP saying:

(Before the contractor visited me and inspected the roof, I didn't think I had any damage.)

So now, someone comes along door knocking, many months after a hail storm and suddenly finds hail damage that the homeowner isn't aware of. This was over 7 months after he switched, unknown how long since the hail storm. Trying to get people to file claims that old is a bit sleazy in my mind.

If it was right after a hail storm, even a couple of months after, I'd consider the contractor a hustling dude (in a positive sense). But at some point, you wait long enough, the claim will get denied AND you won't get a future real claim paid because you had a damaged roof that you didn't repair.

And no, having legitimate claims, especially cat weather claims, doesn't usually impact an agents bottom line. That is rarely a concern.

Dan

 

[Accelerated]

Well, if a contractor doesn't actually do his job and inspect, then of course he is sleazy. You'd have to be a pretty naive person to file a claim based on what your contractor said when he didn't even look at the roof and take pictures...

My beef was about the blanket statement. Seems like the guy did his job and the claims adjuster confirmed he was right. Nothing sleazy about that. And if we have a problem with the fact that he went door to door looking for work then we should delete this thread...

I once called in to make a claim and the agent tried to talk me out of it (as if she knew better). Seemed like she was more concerned about her bottom line. I wonder how many sleazy agent/adjusters there are out there who prevent/deny valid claims. If 10-15%, then I guess the world is even...

As far as agents, I could not speak to it, since my only interaction with agents is when the agent involves themselves in the claims process, and in that capacity, most agents have been quite vocal about helping their insured's, and while some of their requests to "massage the report" to cover specifically excluded losses for their clients can seem extreme at times, it does speak volumes about their desire to retain and service their clients (it's rare but it happens). I honestly have more interaction with agents on this forum than I do running a national claims adjusting firm.

As far as claims adjusters go, I really have not run into those that deny covered losses. The vast majority of adjusters are independent (it's a 4-1 ratio on the national average, much higher in some places), and work on tiered fee schedules or time and expense billing. This tends to cause independent adjusters to err on the side of the insured rather than deny valid claims.

 

[GInsGrp]

Rewriting the policy with company b will usually cause them to run your CLUE report and they will see the claim. Some companies will then adjust the premium or cancel the policy in the first 60 days for misrepresentation. Don't change companies for $20 a month it will cost you more in the long run.