Large homeowner claim for water damage, how much negotiation room
- Thread starter alan226
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@alan226 Dont look at the number, look at the scope of work. See if it's missing anything. I currently have one from an adjuster who put in for replacement on only half of the damage and forgot to put in the removal for the things being replaced.
I've seen flooring be entered as the wrong type, I've seen dimensions be off.
But get the scope right, and then you can call a contractor who can look at the scope and see if there's anything else missing from it. They can also look at the prices and say things like, material cost for x grade is x, and let the adjuster know that their estimate needs to be adjusted. (that's exactly what adjusters do, they adjust your claim to match your loss specifics to make you whole as your policy allows)
The contractor can also see if there was any damage missed, if the equipment estimate was based on the correct class of loss, if the line items are for the correct category.
It's not negotiation in that you are negotiating for more money, you just need to make sure that you have an accurate scope.
I have a large loss adjuster meeting in two hours where I need to get him to change residential rewire to commercial and to change the replace to remove and replace, it's around 50k difference. He's also got replace only for an entire four stall bathroom so I'm going to see if he's coming out to do the demo. (point being there are sometimes mistakes in the estimate. I've billed two toilets in a resi bath myself, easy to make mistakes, reasonable to correct)
I've seen flooring be entered as the wrong type, I've seen dimensions be off.
But get the scope right, and then you can call a contractor who can look at the scope and see if there's anything else missing from it. They can also look at the prices and say things like, material cost for x grade is x, and let the adjuster know that their estimate needs to be adjusted. (that's exactly what adjusters do, they adjust your claim to match your loss specifics to make you whole as your policy allows)
The contractor can also see if there was any damage missed, if the equipment estimate was based on the correct class of loss, if the line items are for the correct category.
It's not negotiation in that you are negotiating for more money, you just need to make sure that you have an accurate scope.
I have a large loss adjuster meeting in two hours where I need to get him to change residential rewire to commercial and to change the replace to remove and replace, it's around 50k difference. He's also got replace only for an entire four stall bathroom so I'm going to see if he's coming out to do the demo. (point being there are sometimes mistakes in the estimate. I've billed two toilets in a resi bath myself, easy to make mistakes, reasonable to correct)
brent_test
New member
jesus%E2%9D%A4%EF%B8%8Fandwantsthebest4u
New member
@alan226 Don't compare the ACV amount to the estimate amount, compare the Adjuster's Replacement Cost Value (RCV), and their scope of work vs the contractor bids. If your contractor bids are not providing an itemized estimate that details out the labor and material costs, quantity and grade level, you will not be able to tell if their estimate is comparable to your adjuster's itemized estimate.
Biggest misunderstanding that people have when it comes to insurance are:
Biggest misunderstanding that people have when it comes to insurance are:
- Not knowing what coverage they actually have, ACV vs RCV coverage.
- Not understanding how their policy works. Most insurers will pay ACV upfront and have recoverable depreciation available when the work is completed.
- The difference between RCV and ACV (RCV is the estimated amount before any deductible, depreciation, or paid when incurred items are deducted).
- Insurance only pays for a repair, not a renovation. While it may make sense for the Contractor and Homeowner to do a renovation when making repairs the policy will likely not pay for that.
- Most policies only pay for same like, kind and quality (LKQ) materials of what you had before the loss occurred, which means if you go back with a upgraded material they will not pay for the upgraded material or labor associated with it.
@alan226 Well, is it truly “low ball”? After all, if you are insured correctly the real numbers to look at is your Replacement Cost cause that is what you should get at completion of repairs.
Unless you have an ACV only policy - in which case that’s on you
In terms of negotiating- you can negotiate grades and scope easier than just flat money
No insurance company I know handles property losses where if you just say a higher number that they just start negotiating numbers
They will negotiate if the cabinets are average or higher grade or premium. Making sure your items/materials are properly graded will go a long way. Then the next thing to look at is are they repairing items that you think need replaced. Like most companies will say reuse the countertops or sinks or faucets but if the countertops break then you have to replace. You have to give them the reason for need to replace and it can’t just be your taste or style or that it’s old It has to be part of the loss not cause you just want it and will throw a tantrum if you don’t get it
Pretty much every company uses Xactimate or a similar- getting a contractor that knows how to write a good accurate estimate that gets everything you need will help
Try to read and understand what your company gives you- the letters and estimate they write will explain the process and what they are paying for. It’s up to you to present your claim in a way that makes it loss related and part of your policy contract
And don’t tell them that they are “lowballing” and “just trying to rip you off”. They aren’t. They are paying what they know they owe at the time with the facts and info they know. Give them more facts and info and cogent arguments for why you feel you are owed what you believe you are
Treat people at the insurance co with respect and they will do the same for you. It’s a job not a way of life or competition for them. They want to get good customer service scores and close claims
Good luck and stay well
Unless you have an ACV only policy - in which case that’s on you
In terms of negotiating- you can negotiate grades and scope easier than just flat money
No insurance company I know handles property losses where if you just say a higher number that they just start negotiating numbers
They will negotiate if the cabinets are average or higher grade or premium. Making sure your items/materials are properly graded will go a long way. Then the next thing to look at is are they repairing items that you think need replaced. Like most companies will say reuse the countertops or sinks or faucets but if the countertops break then you have to replace. You have to give them the reason for need to replace and it can’t just be your taste or style or that it’s old It has to be part of the loss not cause you just want it and will throw a tantrum if you don’t get it
Pretty much every company uses Xactimate or a similar- getting a contractor that knows how to write a good accurate estimate that gets everything you need will help
Try to read and understand what your company gives you- the letters and estimate they write will explain the process and what they are paying for. It’s up to you to present your claim in a way that makes it loss related and part of your policy contract
And don’t tell them that they are “lowballing” and “just trying to rip you off”. They aren’t. They are paying what they know they owe at the time with the facts and info they know. Give them more facts and info and cogent arguments for why you feel you are owed what you believe you are
Treat people at the insurance co with respect and they will do the same for you. It’s a job not a way of life or competition for them. They want to get good customer service scores and close claims
Good luck and stay well
former32%C2%B0mason
New member
@alan226 Mind boggling indeed. Not only do they lowball you but in my situation they didn’t pay for over 7 months. 7 months where I incurred ALE charges. So much so that they’ve paid me more than $15,000 in interest alone. We are fortunate to have been able to cover our costs while waiting out the claim but had we not, we may have been forced into settling for far less than what we were owed.
Here’s an interesting twist. Our insurance company didn’t want to pay to replace the cabinets that were damaged during mitigation (and the damage that they approved, ie removing part of one). The cabinets were total shit. Particle board with a laminate over lay making them “semi-custom.”
The cost to repair the damaged shit particle board “semi-custom” cabinet far exceeded the cost to replace all the cabinets.
Here’s an interesting twist. Our insurance company didn’t want to pay to replace the cabinets that were damaged during mitigation (and the damage that they approved, ie removing part of one). The cabinets were total shit. Particle board with a laminate over lay making them “semi-custom.”
The cost to repair the damaged shit particle board “semi-custom” cabinet far exceeded the cost to replace all the cabinets.
brent_test
New member
@espadinya EDIT - I was responding to another message you wrote, I think.
This sounds EXACTLY like my experience.
I had a pipe burst while I was traveling and hired called my insurance company immediately. Insurer suggested I call ProServ but they never got back to me, so I found my own mitigation company. Mitigation company sets up an insane amount of equipment, fans, dehus, air scrubbers everywhere. They tell me they need to gut my kitchen, downstairs bathrooms, and flood cut through 2700 SF of living space. I ask them to wait until I receive guidance from my insurance company.
I have no idea what to do, where to sleep, or what coverage I have, and I can barely get my adjuster to talk to me. And then, when we're on the phone, there's never any substantiative answers. A lot of "umms", circuitous talking, and avoidance of specifics of any kind. They ask a lot of questions to keep you talking, and prevent themselves from having to say much.
I called and emailed for 10 days straight, trying to get approval for ALE coverage. My house had no running water and the sheer volume of the dehumidifiers and fans made it deafeningly loud. At one point, when pressing him for ALE, the adjuster said "the home may be uncomfortable, but its not uninhabitable". Finally, after escalating to a manager, they agreed I needed ALE.
It's very clear what the name of the game is for the cat teams at major insurance carriers. By initially denying the claim, or portions of a claim, a percentage of the people just give up right there. Maybe that weeds out some insurance fraud, but its definitely denying valid claims, too. Those that push harder will receive a lowball initial settlement, and many will take that chump change offer and either do the work themselves or pocket the money. The homeowners that push harder, or hire a public adjuster, maybe they receive some more money. Claims that hire attorneys, etc. etc. etc.
This is a well-oiled machine we're talking about (insurance industry is worth about $5 TRILLION).
Was your claim a catastrophe loss? I swear - they must be training those adjusters to never put anything in writing. The cat adjuster on my claim probably wrote 10 words for every 5,000 words I wrote, if that. My guess is that most of the people posting here and on r/Insurance sub are likely not cat adjusters.
After 5 months, my insurance had provided only $20k to rebuild the home, even though I was sitting on over $500k total in estimates for mitigation, pack out, and build back. I got fed up, and eventually emailed every executive I could find at the company, filed complaints with every government official that could be concerned with this behavior, and my claim was escalated to its 700th adjuster.
This escalation adjuster was slightly more reasonable at considering my previously denied incurred costs, even admitted that things were handled incorrectly. He even paid me $12k in interest under the Texas Prompt Payment of Claims Act.
The straw that broke the camel's back was my personal property. After paying out about $400k on dwelling, the insurer offered me $11k for contents. Their recommendations included offering $108 to clean my $6,000 mattress + bedframe, a mere $8 to clean a $1,200 designer purse, an an expectation that I provide a technicians report for over 100 items, cables, etc.
Frustrated, I emailed the insurance company executives again, met with officials with the Texas Department of Insurance, opened an OAG: Consumer Protection complaint, emailed the mayor, governor, U.S. Senators & Congressmen, State Senators & Congressmen, the OPIC...basically I emailed everyone but President Biden.
I must've finally pissed off the insurer, because they hired outside counsel and invoked appraisal. They cut off paying my ALE out of spite, and haven't responded to me in 4 months. I wasn't aware that my insurance company could ghost me, but they're doing it.
....that's where I'm at right now.
There's really only been one silver lining here. I realized that I hate my insurer and I will do anything to raise awareness about policyholder rights and that the public adjuster option exists. I've realized that I can't just sit by while these mega corporations keep transferring money from everyday Americans into their own pockets. Insurance executives are making millions, with top CEOs raking in over $10M per year. I want to call for an increase in transparency from the insurance agencies - they should be held to higher standards than what they're able to get away with today.
My experience pushed me to get a public adjuster license of my own, about 2 weeks ago. But I want to do something larger-scale than just handle a few local claims. Just figuring out how to make a difference.
This sounds EXACTLY like my experience.
I had a pipe burst while I was traveling and hired called my insurance company immediately. Insurer suggested I call ProServ but they never got back to me, so I found my own mitigation company. Mitigation company sets up an insane amount of equipment, fans, dehus, air scrubbers everywhere. They tell me they need to gut my kitchen, downstairs bathrooms, and flood cut through 2700 SF of living space. I ask them to wait until I receive guidance from my insurance company.
I have no idea what to do, where to sleep, or what coverage I have, and I can barely get my adjuster to talk to me. And then, when we're on the phone, there's never any substantiative answers. A lot of "umms", circuitous talking, and avoidance of specifics of any kind. They ask a lot of questions to keep you talking, and prevent themselves from having to say much.
I called and emailed for 10 days straight, trying to get approval for ALE coverage. My house had no running water and the sheer volume of the dehumidifiers and fans made it deafeningly loud. At one point, when pressing him for ALE, the adjuster said "the home may be uncomfortable, but its not uninhabitable". Finally, after escalating to a manager, they agreed I needed ALE.
It's very clear what the name of the game is for the cat teams at major insurance carriers. By initially denying the claim, or portions of a claim, a percentage of the people just give up right there. Maybe that weeds out some insurance fraud, but its definitely denying valid claims, too. Those that push harder will receive a lowball initial settlement, and many will take that chump change offer and either do the work themselves or pocket the money. The homeowners that push harder, or hire a public adjuster, maybe they receive some more money. Claims that hire attorneys, etc. etc. etc.
This is a well-oiled machine we're talking about (insurance industry is worth about $5 TRILLION).
Was your claim a catastrophe loss? I swear - they must be training those adjusters to never put anything in writing. The cat adjuster on my claim probably wrote 10 words for every 5,000 words I wrote, if that. My guess is that most of the people posting here and on r/Insurance sub are likely not cat adjusters.
After 5 months, my insurance had provided only $20k to rebuild the home, even though I was sitting on over $500k total in estimates for mitigation, pack out, and build back. I got fed up, and eventually emailed every executive I could find at the company, filed complaints with every government official that could be concerned with this behavior, and my claim was escalated to its 700th adjuster.
This escalation adjuster was slightly more reasonable at considering my previously denied incurred costs, even admitted that things were handled incorrectly. He even paid me $12k in interest under the Texas Prompt Payment of Claims Act.
The straw that broke the camel's back was my personal property. After paying out about $400k on dwelling, the insurer offered me $11k for contents. Their recommendations included offering $108 to clean my $6,000 mattress + bedframe, a mere $8 to clean a $1,200 designer purse, an an expectation that I provide a technicians report for over 100 items, cables, etc.
Frustrated, I emailed the insurance company executives again, met with officials with the Texas Department of Insurance, opened an OAG: Consumer Protection complaint, emailed the mayor, governor, U.S. Senators & Congressmen, State Senators & Congressmen, the OPIC...basically I emailed everyone but President Biden.
I must've finally pissed off the insurer, because they hired outside counsel and invoked appraisal. They cut off paying my ALE out of spite, and haven't responded to me in 4 months. I wasn't aware that my insurance company could ghost me, but they're doing it.
....that's where I'm at right now.
There's really only been one silver lining here. I realized that I hate my insurer and I will do anything to raise awareness about policyholder rights and that the public adjuster option exists. I've realized that I can't just sit by while these mega corporations keep transferring money from everyday Americans into their own pockets. Insurance executives are making millions, with top CEOs raking in over $10M per year. I want to call for an increase in transparency from the insurance agencies - they should be held to higher standards than what they're able to get away with today.
My experience pushed me to get a public adjuster license of my own, about 2 weeks ago. But I want to do something larger-scale than just handle a few local claims. Just figuring out how to make a difference.
@brent_test Oh my gosh! I think we may be cut from the same cloth.
I did file with the CA insurance protection agency but didn’t get far. Luckily I hired the PA early on. I was beyond knowing what to do that I even watched videos on how adjusters are trained and reached out to a woman who trains adjusters in house at insurance companies. I was beyond sane at that point. Ive never felt so “just don’t know what to do.”
I’ve thought about becoming a PA - so awesome! Congrats… that is really impressive. Like you, I go to every extent possible to let people know about PA’s. Even onsite storage delivery companies - the ones who put pods in your driveways. I tell them to tell their clients about PA’s. I’ve also thought about ways to help others out. From informing insureds about quick pay laws to pre-paying rentals for people who can’t afford to sit it out and settle. Maybe we could collaborate on some ideas! No human who has paid for coverage should endure what we have. We paid for a car, don’t give me your apologies, a consultation and a skateboard.
I did file with the CA insurance protection agency but didn’t get far. Luckily I hired the PA early on. I was beyond knowing what to do that I even watched videos on how adjusters are trained and reached out to a woman who trains adjusters in house at insurance companies. I was beyond sane at that point. Ive never felt so “just don’t know what to do.”
I’ve thought about becoming a PA - so awesome! Congrats… that is really impressive. Like you, I go to every extent possible to let people know about PA’s. Even onsite storage delivery companies - the ones who put pods in your driveways. I tell them to tell their clients about PA’s. I’ve also thought about ways to help others out. From informing insureds about quick pay laws to pre-paying rentals for people who can’t afford to sit it out and settle. Maybe we could collaborate on some ideas! No human who has paid for coverage should endure what we have. We paid for a car, don’t give me your apologies, a consultation and a skateboard.
brent_test
New member
@espadinya 1000000000000000000000000000000000%
I have so many documented ways the insurer violated the policy language, state laws, and just commonly agreed on fair dealing/good faith and I want to broadcast it to the world.
I have so many documented ways the insurer violated the policy language, state laws, and just commonly agreed on fair dealing/good faith and I want to broadcast it to the world.
@brent_test Here's a sneak peek of /r/Insurance using the top posts of the year!
#1: Liberty Mutual starting layoffs today
#2: Insurance issued me payment for stolen vehicle this morning but police just found my vehicle.
#3: I got into an accident exactly a year ago. Insurance says I’m at fault now and they are going to pay out the guy $400,000
[sup][sup]I'm[/sup][/sup] [sup][sup]a[/sup][/sup] [sup][sup]bot,[/sup][/sup] [sup][sup]beep[/sup][/sup] [sup][sup]boop[/sup][/sup] [sup][sup]|[/sup][/sup] [sup][sup]Downvote[/sup][/sup] [sup][sup]to[/sup][/sup] [sup][sup]remove[/sup][/sup] [sup][sup]|[/sup][/sup] [sup][sup]Contact[/sup][/sup] [sup][sup]|[/sup][/sup] [sup][sup]Info[/sup][/sup] [sup][sup]|[/sup][/sup] [sup][sup]Opt-out[/sup][/sup] [sup][sup]|[/sup][/sup] [sup][sup]GitHub[/sup][/sup]
#1: Liberty Mutual starting layoffs today
#2: Insurance issued me payment for stolen vehicle this morning but police just found my vehicle.
#3: I got into an accident exactly a year ago. Insurance says I’m at fault now and they are going to pay out the guy $400,000
[sup][sup]I'm[/sup][/sup] [sup][sup]a[/sup][/sup] [sup][sup]bot,[/sup][/sup] [sup][sup]beep[/sup][/sup] [sup][sup]boop[/sup][/sup] [sup][sup]|[/sup][/sup] [sup][sup]Downvote[/sup][/sup] [sup][sup]to[/sup][/sup] [sup][sup]remove[/sup][/sup] [sup][sup]|[/sup][/sup] [sup][sup]Contact[/sup][/sup] [sup][sup]|[/sup][/sup] [sup][sup]Info[/sup][/sup] [sup][sup]|[/sup][/sup] [sup][sup]Opt-out[/sup][/sup] [sup][sup]|[/sup][/sup] [sup][sup]GitHub[/sup][/sup]
brent_test
New member
@brent_test me too. although mine was closer to 10k/100k/300k with ALE and their BS games. it’s lowballing and it’s illegal. my claims adjuster said the field reps don’t carry moisture meters with them. What? The dispute was over moisture so why would he not take moisture readings?
brent_test
New member
@espadinya I had the exact same scenario. Quote: "they don't let us address moisture meter readings". I had a water loss, and you mean to tell me you don't use industry-standard technology to determine the scope of my loss?
The reason is that they don't want to properly investigate your loss - means they have to pay more money on the claim.
Also, it never ceases to amaze me that we get downvoted by the adjusters on these subs because they truly believe that they have never underpaid a homeowner before. Mind boggling.
The reason is that they don't want to properly investigate your loss - means they have to pay more money on the claim.
Also, it never ceases to amaze me that we get downvoted by the adjusters on these subs because they truly believe that they have never underpaid a homeowner before. Mind boggling.
Helpful comments. I am breaking the negotiation up into three parts. First is understanding if the scope of work is adequate(are materials the correct materials?, are they missing items relevant to bringing the repair back to standard, are there the potential for mismatched items that aren't resolvable (ie upper cabinet don't match the lowers now?). Second is if the items that are depreciable are calculated correctly. Lastly if the quoted RCV is in line with our communities trade rates.