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JimN
07-27-2010, 10:04 PM
I have some questions about homeowners' insurance and added endorsements that involve heavy rain, sewer backup, sump pump overflow and power outages.

It may be better to do this privately, but I have no problem using a thread for it.

If I have sewer backup and sump pump overflow coverage, how is it that the insurance company can tell me that they may not cover the damage from "100 year rain", when we got two in one week and have had the wettest July on record? They told me that, because water from under the foundation intermingled with water that came from the sump crock, they have a "concurrent event" exclusion. I see no difference between the water that comes through any existing cracks and what comes from the sump crock- if the foundation was totally water-tight, more water would have come out of the sump crock. It didn't pour into the house from outside, it seeped in and because the power went out for almost 7 hours, the sump crock overflowed.

What moron would sign up for this kind of coverage if they know or think they won't be covered by both events that they're paying premiums for?

Thanks, in advance.

KnoxX2
07-27-2010, 10:05 PM
I have a friend

PM at ya

ttu
07-27-2010, 10:10 PM
jim, i have been a agent for 14 years and before that 3 years being a claims adjuster. laws do vary in each state but shoot me a pm and we can chat from there.

monte is also a agent but i have not seen him post in sometime.

db

ahhudgins
07-27-2010, 10:41 PM
My wife is an agent and I'll let her explain:

Water backup is totally separate from seepage. Seepage is excluded from most every policy. You will need to determine exactly where the water came from. I suggest you get photos and have someone qualified (not the insurance adjuster) look at it and put in writing before the water is gone. Let the insurance company send the denial [I]in writing[I]. If you can show the damage came from the water backup and IF you had that option on your policy then they should not deny the claim. Know that just because a company denied a claim does not mean that is correct. This happens all the time with erroneous denials. I am not aware of any company out there that offers seepage. It sounds like flood could be a consideration here too--maybe.

Hoosier Bob
07-27-2010, 10:47 PM
I did sleep at a Holliday Inn last night!:D

ahhudgins
07-27-2010, 10:48 PM
I feel your pain. My wife and I have heated discussions on a regular basis concerning insurance coverages. You used to be able to just buy an insurance policy that covered damage to your house, but now you have to buy additional coverage for all of the exclusions only to find out that you still aren't covered.

Hoosier Bob
07-27-2010, 10:52 PM
May not apply but the fact is most if not all insurance companies will be looking for ways to avoid claims. Think people are only dropping health coverage? Facts are false claims are up and income is down. This being said my guess is all claims are being scrutinized beyond the norm. Insurance is nothing more that measured risk. They can also measure odds that you will walk instead of fight. Keep pushing and tell them Hoosier said he would kick their a**!;)

dmminfla
07-27-2010, 10:58 PM
Here in south florida we have lot's of insurance. the windstorm coverage covers any water entering the home through wind related storms. But if water rises and intrudes the home it is considered flood water and is not covered unless you have a flood policy which is not that expensive and government sponsered.

JimN
07-27-2010, 11:00 PM
My wife is an agent and I'll let her explain:

Water backup is totally separate from seepage. Seepage is excluded from most every policy. You will need to determine exactly where the water came from. I suggest you get photos and have someone qualified (not the insurance adjuster) look at it and put in writing before the water is gone. Let the insurance company send the denial [I]in writing[I]. If you can show the damage came from the water backup and IF you had that option on your policy then they should not deny the claim. Know that just because a company denied a claim does not mean that is correct. This happens all the time with erroneous denials. I am not aware of any company out there that offers seepage. It sounds like flood could be a consideration here too--maybe.

I have photos but in some light, standing water doesn't show up as more than the reflection of any light bulbs in the photo. The water is basically gone. I do have some cracks in the floor and the one universal comment I have heard from anyone who works with concrete is, "Concrete cracks". That's why control joints are cut, so it will crack where they want it to. I fail to see how they expect the water to stop at a control joint, though. I know cats don't like to step over cracks but I know for a fact that water doesn't give a rat's asss if something is in the way.

I saw the water coming out of the sump pump cover. I guess I should have shot a video but I didn't expect to hear that I might not be covered. It also stood at the floor drain, which connects to the sanitary sewer, not a rainwater drainage system. I DO have sewer backup coverage and I DO have sump pump overflow coverage. I'm not in a flood plane and flood insurance isn't required, per my mortgage. If I had thought I'd be dealing with this now, I would have bought it- where I am, it's not very expensive.

Thanks for the quick reply.

JimN
07-27-2010, 11:06 PM
May not apply but the fact is most if not all insurance companies will be looking for ways to avoid claims. Think people are only dropping health coverage? Facts are false claims are up and income is down. This being said my guess is all claims are being scrutinized beyond the norm. Insurance is nothing more that measured risk. They can also measure odds that you will walk instead of fight. Keep pushing and tell them Hoosier said he would kick their a**!;)

They avoid claims because they often have shareholders and those people like dividends. OTOH, EVERYONE'S insurance went up in the late '80s because of the bad investments by the insurance industry. I suspect that's why most of the insurance companies around here have big, new headquarters.

Last time I talked with a friend about insurance and what a scam it is, I walked outside of the club to find that my car had been stolen. Insurance is the policyholder betting that they will have an incident and the insurer betting that the insured won't. For a fee. The rub is that the insurer can deny claims, even though they risk losing my business, I have never filed a claim with this company and I have several policies. What I have paid in premiums is far more than this claim will cost, if they pay it.

Hoosier Bob
07-27-2010, 11:08 PM
How does any insurance company make money? By not paying claims! God forbid it is by assessing risk, pricing and customers accordingly. :D My point was regardless of verbiage fight until paid. Let them **** someone else. They avoid claims because they often have shareholders and those people like dividends. OTOH, EVERYONE'S insurance went up in the late '80s because of the bad investments by the insurance industry. I suspect that's why most of the insurance companies around here have big, new headquarters.

Last time I talked with a friend about insurance and what a scam it is, I walked outside of the club to find that my car had been stolen. Insurance is the policyholder betting that they will have an incident and the insurer betting that the insured won't. For a fee. The rub is that the insurer can deny claims, even though they risk losing my business, I have never filed a claim with this company and I have several policies. What I have paid in premiums is far more than this claim will cost, if they pay it.

JimN
07-27-2010, 11:15 PM
How does any insurance company make money? Bu not paying claims! God forbid it is by assessing risk and customers accordingly. :D My point was regardless of verbiage fight until paid. Let them **** someone else.

Fortunately, I have a customer whose family has several big-time lawyers. There are several potential targets for my suit, if needed. My agent, whom I have known for over 30 years, the agency, the company, Milwaukee County (two lawyers are exploring whether a lawsuit has merit, since they were flooded twice last week and also the week before, because of the pisss-poor sewerage district we have). Not only do I have material loss (it's not a lot of valuable things, but still,...), the drywall was damaged and now has mold growth and will require materials & labor to replace/paint and because the area was flooded due to the negligence of Milwaukee County WRT their dam, my property value will drop. I hate the thought of going through a lawsuit but I'm not gonna let them screw me, either. Fortunately, I can claim up to $500 for food that was damaged by a power outage and you can be that I will.

Hoosier Bob
07-27-2010, 11:19 PM
Nice! The Insurance company's lack of quick and appropraite response compounded the damages! I like the way you work Jimmy!;)Fortunately, I have a customer whose family has several big-time lawyers. There are several potential targets for my suit, if needed. My agent, whom I have known for over 30 years, the agency, the company, Milwaukee County (two lawyers are exploring whether a lawsuit has merit, since they were flooded twice last week and also the week before, because of the pisss-poor sewerage district we have). Not only do I have material loss (it's not a lot of valuable things, but still,...), the drywall was damaged and now has mold growth and will require materials & labor to replace/paint and because the area was flooded due to the negligence of Milwaukee County WRT their dam, my property value will drop.

JimN
07-27-2010, 11:28 PM
Nice! The Insurance company's lack of quick and appropraite response compounded the damages! I like the way you work Jimmy!;)

Actually, the power went out twice- Thursday night in the first storm and Friday night, at about 1:30AM, during another night of constant rain. How they expect my sump pump to keep up with that, especially WHEN IT'S NOT GETTING ANY POWER, is beyond me. Also, my insurance covers damage from sump overflow even if the pump itself fails.

As the Tom Waits song says, "The large print giveth and the small print taketh away".

ttu
07-27-2010, 11:55 PM
May not apply but the fact is most if not all insurance companies will be looking for ways to avoid claims. Think people are only dropping health coverage? Facts are false claims are up and income is down. This being said my guess is all claims are being scrutinized beyond the norm. Insurance is nothing more that measured risk. They can also measure odds that you will walk instead of fight. Keep pushing and tell them Hoosier said he would kick their a**!;)

hoosier bob, i will agree and disagree with your statement. yes the big "3" have been known for this but not all companies. in 08 we had a very large hail storm in the area that i write a majority of my property business that i have on the books. we paid 3.3 million in roof claims alone with a 6% denial ratio. two of the big three denied 32% percent of the claims that were called in. the other was around 16%.

i will look into this in the am and get back with jim after i talked with my home office claims vp to give him a better understanding if his is a covered loss or not.

Hoosier Bob
07-28-2010, 12:04 AM
But you half agreed right? I can definately live with that! I was just bs'ing anyway! :D
PS! Do not believe anything you read on the internet or I say!hoosier bob, i will agree and disagree with your statement. yes the big "3" have been known for this but not all companies. in 08 we had a very large hail storm in the area that i write a majority of my property business that i have on the books. we paid 3.3 million in roof claims alone with a 6% denial ratio. two of the big three denied 32% percent of the claims that were called in. the other was around 16%.

i will look into this in the am and get back with jim after i talked with my home office claims vp to give him a better understanding if his is a covered loss or not.

JimN
07-28-2010, 01:04 AM
hoosier bob, i will agree and disagree with your statement. yes the big "3" have been known for this but not all companies. in 08 we had a very large hail storm in the area that i write a majority of my property business that i have on the books. we paid 3.3 million in roof claims alone with a 6% denial ratio. two of the big three denied 32% percent of the claims that were called in. the other was around 16%.

i will look into this in the am and get back with jim after i talked with my home office claims vp to give him a better understanding if his is a covered loss or not.

If I was trying to scam them and pad my claim, I'd list a couple of expensive things and probably have a string of claims, creating a long paper trail and a pattern of fraud. It already cost me because I felt it necessary to try to clean up the mess instead of doing some of the work I have lined up and by dong that, trying to keep the wood from rotting. The seepage wasn't the major amount of water- at most, it got to 1" because that small part of the floor is uneven but when I had seen it several inches deep because the water wasn't going down the drain, I called the agency later that day. If I have a little water seeping in, boo hoo. I can clean it up and go on my merry way but when I see inches and it's up the drywall, I want to be covered.

What about power outage- is that usually covered? They pay for damaged food- why not water coming in due to the sump pump not going on? I have never had the power go out for more than maybe a half hour, ever. This time, it was almost 7 hours the first night and over 2 hours the next.

ahhudgins
07-28-2010, 11:26 AM
My wife said that the best thing to do is wait until your agent gives you some thing in writing. If they deny your claim, they will have to site some specific clause in your policy. I hear these types of events on a weekly basis and a lot of times the adjustor that comes out to look at the damage doesn't have a clue about your policy. I didn't know until today that even if you purchase "flood insurance", there has to be a certain number of houses involved (or acreage) before you are covered.

Thrall
07-28-2010, 11:36 AM
Sorry to hear about this BS Jim, but on a semi related note the flood insurance that dmminfla talekd about, is all govt sponsored, through the insurane carriers. To my knowledge you cannot buy flood insurance that is sponsored privately and the govt has set a cap on what you could be insured for and it's LOW! Like $250k tops IIRC.
I looked into it when buying our last house, near a river, but way above the 100 yr flood level and found out that the flood insurance isn't worth a cr@p if you have an expensive home.
Any insurance agents, please correct me if I'm wrong as I may be getting xferred to FL soon and will need to be up on the flood insurance gig.

JimN
07-28-2010, 12:42 PM
Sorry to hear about this BS Jim, but on a semi related note the flood insurance that dmminfla talekd about, is all govt sponsored, through the insurane carriers. To my knowledge you cannot buy flood insurance that is sponsored privately and the govt has set a cap on what you could be insured for and it's LOW! Like $250k tops IIRC.
I looked into it when buying our last house, near a river, but way above the 100 yr flood level and found out that the flood insurance isn't worth a cr@p if you have an expensive home.
Any insurance agents, please correct me if I'm wrong as I may be getting xferred to FL soon and will need to be up on the flood insurance gig.

$250K cap- just another example of a government telling people what they can and can't have. I guarantee that if a Senator or other high-ranking member of our government is flooded out, they'll be covered.

ahhudgins
07-28-2010, 06:45 PM
$250K cap- just another example of a government telling people what they can and can't have. I guarantee that if a Senator or other high-ranking member of our government is flooded out, they'll be covered.

What Thrall said about the government flood insurance is correct.
Just to add salt to your wounds, the money that people pay insurance companies for “flood insurance” goes into a general fund. You can have a 1 million dollar house on a lake or beach and pay a high premium, but like you said there is a cap. When an area has been considered a disaster area after a hurricane (like Katrina), FEMA uses this money to pay out losses to people who never paid a dime of flood insurance. A lot people believe that flood insurance only benefits rich people because they can keep rebuilding their houses on the beach after a major storm, but most of the money gets spent on rebuilding houses that DIDN’T have insurance. Where did FEMA get the money to pay for all of those trailers, hotel rooms, and rooms on cruise ships? Insurance premiums and tax payer dollars.

My wife will be glad to give you any suggestions once your insurance company gives you some thing in writing, but you may be surprised that you are covered once your agent gets involved. There are good and bad adjustors and agents just like any profession. My wife goes out of her way to make sure her customers get what they pay for (which pisses her boss off some times). :rolleyes:

cbryan70
07-28-2010, 11:54 PM
hoosier bob, i will agree and disagree with your statement. yes the big "3" have been known for this but not all companies. in 08 we had a very large hail storm in the area that i write a majority of my property business that i have on the books. we paid 3.3 million in roof claims alone with a 6% denial ratio. two of the big three denied 32% percent of the claims that were called in. the other was around 16%.

i will look into this in the am and get back with jim after i talked with my home office claims vp to give him a better understanding if his is a covered loss or not.

.................

JohnnyB
07-29-2010, 09:44 AM
JimN....never realized you were in WI. Where around Milwaukee are you?

You guys sure got a crap load of rain.....saw lots of pictures in our local news. My relatives in your area faired OK given how much rain they got.

Not to thread jack, but my parents have a waterfront home below a large ridge and their sump constantly runs due to the natural flow of water into the area their house is built on. My dad has battery and generator backup on his sump basically because if his sump quits running during any wet time for more than an hour or two, he'll have a new swimming pool.

I'm going to pass this experience and the contributions of the others to the subject on to him as I think he needs to ask some questions of his insurer.

Hope you can reach some reasonable result with your insurer.

JimN
07-29-2010, 11:04 AM
JimN....never realized you were in WI. Where around Milwaukee are you?

You guys sure got a crap load of rain.....saw lots of pictures in our local news. My relatives in your area faired OK given how much rain they got.

Not to thread jack, but my parents have a waterfront home below a large ridge and their sump constantly runs due to the natural flow of water into the area their house is built on. My dad has battery and generator backup on his sump basically because if his sump quits running during any wet time for more than an hour or two, he'll have a new swimming pool.

I'm going to pass this experience and the contributions of the others to the subject on to him as I think he needs to ask some questions of his insurer.

Hope you can reach some reasonable result with your insurer.

I'm in a 'burb just to the North.

If he's on a lake, he's in a flood plane, which is different from my place, which isn't.

ttu
07-29-2010, 12:46 PM
.................

what in the heck does that mean?? btw are you not suppose to be studying!!:cool:

scott023
07-29-2010, 12:59 PM
what in the heck does that mean?? btw are you not suppose to be studying!!:cool:

That means he opened up and said what he was thinking. He went back and read it, only to determine that it made absolutely no sense. Being unable to delete the post, he replaced it with "...........................". :D

ttu
07-29-2010, 01:06 PM
That means he opened up and said what he was thinking. He went back and read it, only to determine that it made absolutely no sense. Being unable to delete the post, he replaced it with "...........................". :D

i know what he meant!:) it was a inside joke.

cbryan70
07-29-2010, 01:31 PM
what in the heck does that mean?? btw are you not suppose to be studying!!:cool:

Yes learning all about lending currently. Leave tomorrow after noon for more training

scott023
07-29-2010, 02:15 PM
i know what he meant!:) it was a inside joke.

I knew you knew what he meant. I just like to throw jabs at Bryan when I can. :D