Two Deductibles on the Same Claim?

[Gen1GT]

Hello everyone. Last summer, I had wind damage to my home, which resulted in some roof damage. The wind had blown away some shingles, which resulted in leakage that caused internal damage to the home.

The insurance company sent out their approved contractor to inspect the damage, and the roofing sub-contractor did a quick patch of the missing shingles. The claim was processed and we settled on amount to repair the damage to the interior of the home. At this point, I thought the case was closed.

I've been recently contacted by my adjuster (this was unsolicited) at the request of his Underwriting Department. They reviewed the file and realized the roof repair was neither approved nor taken care of, and I guess they decided it should be fixed properly to avoid a future catastrophic claim. They have used the previous roof replacement estimate, which was done during the claim last summer, as a basis for the repair work, but also asked that I get a second estimate for the replacement of the rest of our roof (they want to see it all replaced because of its age and condition).

Here's the kicker; he reminded me that although they're paying for the repair work, I'm on the hook for a $1000 deductible. Should I have to pay a second deductible on work that should have been completed on the first claim? I paid the $1000 deductible in the summer when the event occurred, so shouldn't that deductible cover this repair as well? It's not my fault they didn't dot their T's and cross their I's, is it?

 

[djs]

I don't think he meant paying the deductible a second time, I think he was reading from his mental script, just reminding you that the deductible applies. In this case, you will not be reimbursed for the deductible you already paid.

To the adjuster, its a line item in his worksheet. To you, its a skipped heartbeat. In general though, only one deductible per occurrence (claim). You had 1, so one deductible.

I would confirm this with the adjuster, but I wouldn't panic unless he says otherwise.

Dan

 

[Gen1GT]

Hi DJs, thanks for the reply.

Just to be clear, you don't think he's trying to turn this into two claims? They can't create two claims for the same incident, can they?

 

[VolAgent]

Hi DJs, thanks for the reply.

Just to be clear, you don't think he's trying to turn this into two claims? They can't create two claims for the same incident, can they?

Odds are, it is just something he has said something so often, it is just second nature and he didn't think about it.

To be safe, call him and ask.

 

[djs]

From the way you described it, there should be one claim.

What I'm guessing happened is the roofer did a quick patch job to prevent further damage and was supposed to come back and actually do the real work when time permitted. For what ever reason, that didn't happen. The carrier was holding the claim open till the real bill came in, which didn't happen. They eventually contacted the roofing company, checking on the work status, who said......'ooopppppssss'. At least, they admitted this, which is good.

Then the insurance company, not wanting yet another claim, contacted you to get the work completed. Now, the adjuster came out and looked to verify the work wasn't done and then is proceeding with his job to get it done.

Your insurance company deserves some recognition for following up on the claim, rather than just closing it out due to time elapsed.

Dan