Question Of Pain (OT), Pics added Options

[VaccaRabite]

And now, for our next contestant on the Question of Pain, with your host Swampyyyyy Bottoms!

Vacca Rabite, what sits about 735 feet above the sea, but is currently full of water?

Gee Swampy, lemme think about that one. Oh, I know. Is it "My House?"

Thats RIGHT! Jimbob, tell the poor sap what he's won!

Well Swampy, Mr Rabite has won a burst radiator. On the top floor of his house. Its been pumping out hot water at 20PSI for many hours now. He will get to enjoy water cascading beautifully out of all of his recessed light fixtures on the floor directly below his new burst radiator. He gets a new in house pool in his basement. He will also get to enjoy looking at new cracks in his ceiling and walls. All this sounds great, but there is more. Mr Rabite will get to spend the rest of the night pulling up sopping wet carpet and foam, while trying to stave off mold. And if you thought that was enough, just wait to hear what else he's won. Mr Rabite will get to replace his computer, DSLR, several lenses, his brand new HD video camera, and his cell phone. And last, but not least, he'll get to deal with insurance adjusters!

Jimbob, those are some great prizes. Vacca, what do you think of all the loot you get here tonight.

....... Um. This game show blows.

Whe-he-hell... Everybody come on back next week for another exciting edition of The Question of PAIN!

Brought to you by the Awesome Squad! Paid for by USAA.

[ottox914]

First off, here is my bias. I am property insurance adjuster. Before you all go and throw your used and broken 914 parts at me, lets talk a little. Not all insurance adjusters are evil and should be destroyed, just as all used car salesman do not wear plaid jackets and warranty their cars for 5 miles or 5 blocks, which ever comes first. I've been doing this for 20 yrs now, so I think I have a handle on the basics, although I do not work for USAA, so I can not comment specifically on how I think the coverage would/could/should apply in this case.

Assuming this is a fairly "standard" HO family of policy, or a usaa form similar to the ISO HO series, I would have a couple observations.

1- 99.9% of homeowners policies, for an owner occupied home, will have an additional living expense line of coverage. This is "triggered" when there is a covered loss which makes your home unfit to live in. Sounds like this is what we have going on here. If a person was to have stayed in a motel, those bills should be part of the covered loss. If your pets need a motel, same would apply. With my company, I have paid for pet boarding many times. I have also paid for time living at a friend or relatives home. But. This has been an agreed to, nominal fee per day, not the going rate for a holiday inn or similar lodging option. Your friend is not in the "business" of renting out rooms, and should not be paid as such, unless he wants to serve up his SS #, so any lodging fees paid to him would be considered taxable income. Usually more hassle than most folks want to go thru. but still, ask your adjuster about your additional living expense coverage.

2- Be careful of what you ask for. Again, I do not know what the coverages are that are provided by your policy, and I say this not to freak you or anyone else out, but damage does not always = coverage. In some of our lower priced, more limited policies, there is no or limited coverage for code upgrades, or mold, to pick 2 examples. There was a claim where an individual got way overheated, called in the health inspector for his county, the housing inspector, a mold testing firm, an independent appraiser, and a couple builders. He was going after his adjuster with all guns loaded. He identified damages such that the county would not let him live in the home until all the work was done. His policy had limits to the amount it could pay for the damages he identified. The individual would not accept this, and was looking to bulldoze his way to a better settlement. In the end, the adjuster correctly assessed the damages and paid the limit, the home owner created a giant project for the re-building, much of which had to come out of his pocket. The bad: he ran out of coverage well before he ran out of repairs. The good: he now had a total scope of repairs and costs for these repairs lined up. The ugly: he went after his agent claiming he was sold the wrong policy. I don't know how that ended. It was not my claim.

I have nothing against folks getting a 2nd or 3rd opinion on my scope of damage, but presentation is everything. Give me this info as something additional to my own observations and experience to consider, document why your thoughts are different from mine, and don't try to ram it down my neck as fact and the only claim resolution you will accept.

This brings me to my 3rd thought:

3- Work with your adjuster, not against him/her. You, like everyone else I deal with, has had, to one degree or another, an event in their lives that has turned things upside down. Things are not as they should be. As odd as this sounds, now is not the time to be demanding ME, ME, ME, but rather to be asking what can I do to make the adjusters job easier. Hear me out, here. Your adjuster may have 10-20 or more claims just like yours, all in different stages of done. Some may have just been reported, others needing the last check written, most are somewhere in the middle. Keeping all this organized with paper was a nightmare, and computers mean now there are more people able to look over your shoulder and "score" your work. Ask questions, try to understand the process, and help with it. Oddly enough, the folks who participate and help me round up the info needed to write checks, seem to get the checks sooner. Your computer is a great example. Rather than just tell the adjuster it was a 3 yr old dell whatever, you got the specs and prices for a matching replacement unit. My job just got easier, now I can write you a check rather than spend 1/2 an hour or more tracking down specs for a like kind and quality unit. We're working togather and you're getting paid sooner, getting back to normal sooner. Your adjuster has quality standards his file needs to stand up to for contact, returning calls, documentation of the file, and the sooner the two of you hit those marks, the faster your claim will be concluded.

4- Lastly, on a property claim such as this, its OK to cash the check. To many people lump ALL insurance checks into one category. In a liability claim, say I'm in your car, you are driving, and in showing off you smack us into a tree. I'm making a claim against your policy for my injuries. (thats an important sentence). Your insurance company has no contract (policy) with me, but they do owe me some money. They are going to want me to "sign off" on my claim, take their money, and go my merry way. That is different from your situation. Here you are making a claim against your policy for damages to your property, which your insurance company insures. (compare this to the last important sentence). You have a contract (policy) with your company, that says you pay them $$$ a yr, and when things go wrong, the contract (policy) will define how both parties will be affected. (coverage and payment or denial of coverage, depending on the cause of loss). If there are additional damages that are realized during the construction, or if the adjuster missed something, or did not price it correctly, the terms of the contract have not been met, your company would need to write you an additional check(s) until the terms of the agreement (policy) have been satisfied.

And, if you would like to discuss more, pm me your phone #, I'll be glad to help as I can.