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Filing an Insurance Complaint

Old 11-10-2018, 06:16 AM
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Default Filing an Insurance Complaint

Just seeing if it will actually do any good, or if this is one of those things that happens so often people who receive them just dont actually care.

Backstory is hit by Florence, filed claim on 15th of Sept. Two weeks later get called by adjuster for Inspection date set for Oct 6th. Oct 6th shows and adjuster calls with some excuse saying cant make it and I get first available appt which is now the back of the line.
Oct 13th comes while I am driving to meet someone I get a call from the adjuster, says he has a 2hr window can squeeze me in now instead of waiting another week for appt so I go for it.
He does the inspection, measures, all seems good. He said he will submit it that day and should hear back in about a week, if not call the desk jockeys to check status.
I wait till the 24th of Oct to call and check up, told its awaiting final review, should only be another couple days. Another week goes by, give a call, same story, another week goes by, and call and get the same story. Waiting on approval but actually get told the preapproval amount.
Next day get a call from adjuster saying my claim has been kicked back several times and because of that he was giving the claim and needs to come out to redo measurements and other crap. Sets appt for today at 0900, get called at 0830 to reschedule to 1100.



At this point I am ready to go apeshit on someone but know enough to remain calm until I get this inspection done. What say THT is the best way to handle? File complaint, burn my house down with inspector on the roof, what say you.
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Old 11-10-2018, 07:10 AM
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First thing I would do is call my agent and ask him to intervene. If that does not help I would file a complaint with the State Insurance Commissioner; in Florida you can do it on line. Never done one so no clue if it works. The other option is to hire an attorney who specializes in disputing insurance claims/settlements.
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Old 11-10-2018, 07:25 AM
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I had a similar thing with my flood adjuster following Katrina. I called my agent and told my agent that I demanded a new adjuster. I got one who was much better. Insurance companies hold all the cards though, and often you have no recourse. Insurance commissioners are politicians and most get the majority of the campaign finance dollars from insurance companies, so it's not likely you have a real ally in the commissioner.
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Old 11-10-2018, 07:28 AM
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I've had to reschedule a few times because of rain or some kind of unexpected feeling under the weather. Stuff happens, but I try to get there as soon as possible.

Adjusters write their estimates and reports and submit them for review and approval. I've had examiners reject my files/estimate multiple times and it's frustrating as hell. Sometimes you put things in the estimate and the file examiner can't see it in the pictures.....you gotta remove it from the estimate or explain it. Sometimes you don't put something in the estimate and you get told to add it.....sometimes you miss stuff. Most likely (and it's only a guess), the adjuster submitted his report and it got rejected by an examiner because the adjuster missed a photo he probably should have taken or a something wasn't measured and it's gotta be in the file.

Sounds like your adjuster has been working since mid-September and is still in the field adjusting claims. That's probably 7 days a week seeing 3-4 claims a day (or more) with all the stuff that goes into putting together a report ---- setting up the estimating software file, uploading photos and labeling them, creating a sketch in the estimating software file, writing the estimate and finally a detailed report.....that can take 3-4 hours per file, depending how complicated the file is. That means being on the road during all the day light hours and working until mid-night doing reports. Throw in a bunch of file rejections and you get behind real quick in your work.

You can call the insurance commissioner and file a complaint. It will be taken seriously and the insurance company will make a call to the adjuster and tell him/her to give your file 100% attention.
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Old 11-10-2018, 07:29 AM
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There is nothing........nothing....that you can do to speed up the process unless you think that taking the first offer will help you out (it won't). Storm adjusters are hired guns that push paper as fast as they can in order to get the commission. If your insurance company's Large Loss manager wants to go with the least possible payment, they tell the adjusters to short-ball their estimates. What might have happened with your claim is that the company saw evidence that the adjuster was being too.....ahem...fair with you, and are tying it up in order to get a lesser amount.

After Ivan, we went through 6 adjusters within the course of a year, and the final amount was 4X what the first couple were. They save money with both big and little things; case in point, I had two revolvers that were blued, and had been in salt water for days. Adjuster gave $40 for a cleaning of those rust-buckets...which is the kind of line item that you want to uncover in order to confront the company with a more equitable settlement before you go the public adjuster route.

P.S. Why do you think that you need to be there in order for the house to be inspected? You serve no useful purpose looking over his shoulder.
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Old 11-10-2018, 07:34 AM
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And to add.....when I worked hurricanes, the people I got to a customers home in the first days after the storm were surprised and pleased I got there so fast. When you roll up to the house 85 days later.....folks are quite as nice and pleasant.....it was always "what the hell took so long!"
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Old 11-10-2018, 07:34 AM
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Originally Posted by Paul Barnard View Post
I had a similar thing with my flood adjuster following Katrina. I called my agent and told my agent that I demanded a new adjuster. I got one who was much better. Insurance companies hold all the cards though, and often you have no recourse.
Thats what I am trying to figure out, NC pulled wind/hail a few years ago and require it to be separated. So that Insurance is through my primary homeowners but is a sub insurance through another group, NC Joint Underwriters Association. The crazy thing has been NCJUA hasnt handled any claims, there letting other companies do all the claims on their behalf and just paying for it. So I have the claim through NCJUA, being handled by State Farm, whose using Pilot for their field adjusters. The fella who is supposed to be coming today is from a completely different company that I will have to get written down when he arrives.

Its just frustrating, the adjuster coming has only said needs to measure the ridge vents and a room or two because of something.
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Old 11-10-2018, 07:40 AM
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Originally Posted by bamaboy473 View Post
There is nothing........nothing....that you can do to speed up the process unless you think that taking the first offer will help you out (it won't). Storm adjusters are hired guns that push paper as fast as they can in order to get the commission. If your insurance company's Large Loss manager wants to go with the least possible payment, they tell the adjusters to short-ball their estimates. What might have happened with your claim is that the company saw evidence that the adjuster was being too.....ahem...fair with you, and are tying it up in order to get a lesser amount.

After Ivan, we went through 6 adjusters within the course of a year, and the final amount was 4X what the first couple were. They save money with both big and little things; case in point, I had two revolvers that were blued, and had been in salt water for days. Adjuster gave $40 for a cleaning of those rust-buckets...which is the kind of line item that you want to uncover in order to confront the company with a more equitable settlement before you go the public adjuster route.

P.S. Why do you think that you need to be there in order for the house to be inspected? You serve no useful purpose looking over his shoulder.
Needs to measure the inside of my house and part on the outside. I got several dogs that may not react appropriately, dachshunds are a holes at time.
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Old 11-10-2018, 07:40 AM
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Your best recourse is likely just to be patient and let the process play out. My flood adjuster was an insufferable mouthy prick. I didn't care if it delayed my claim, but I was NOT going to deal with him for one more second. I am satisfied that insurance companies purposefully move slowly so that when you are presented with an offer you are tempted to take it just to get it over with. An insurance company has no real duty to operate in good faith, to operate quickly, to operate fairly, to operate efficiently or otherwise do what they should do.
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Old 11-10-2018, 07:41 AM
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Originally Posted by bamaboy473 View Post
There is nothing........nothing....that you can do to speed up the process unless you think that taking the first offer will help you out (it won't). Storm adjusters are hired guns that push paper as fast as they can in order to get the commission. If your insurance company's Large Loss manager wants to go with the least possible payment, they tell the adjusters to short-ball their estimates. What might have happened with your claim is that the company saw evidence that the adjuster was being too.....ahem...fair with you, and are tying it up in order to get a lesser amount.

After Ivan, we went through 6 adjusters within the course of a year, and the final amount was 4X what the first couple were. They save money with both big and little things; case in point, I had two revolvers that were blued, and had been in salt water for days. Adjuster gave $40 for a cleaning of those rust-buckets...which is the kind of line item that you want to uncover in order to confront the company with a more equitable settlement before you go the public adjuster route.

P.S. Why do you think that you need to be there in order for the house to be inspected? You serve no useful purpose looking over his shoulder.
In 29 years, I've never been told to short ball, low ball, try to write my estimates as low as possible. I think most times the problem lies with estimating softwares....Xactimate / Symbility / Simsol to name a few. Say I want to remove furniture out of a room....I have 3 options for removing and resetting contents in a room - Room - Large Room - Extra Large Room. I've seen some huge rooms with 1-2 pieces of furniture but the walk in closet likely would take a couple of hours to clean out. You can fudge room size, but you can't change the dollar amount assigned by the software package. Same for drywall, studs, flooring, paint.....
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Old 11-10-2018, 07:50 AM
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It is a very frustrating process. Went through the same with Irma. Only advice I can give you is to keep hounding them, the squeaky wheel does get the grease. In the Keys I think it was worse, as you are so limited to contractors doing work for the amount the insurance company's software says it should cost. All the contractors just laugh when they see what the insurance co thinks it should cost. Good luck to you.
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Old 11-10-2018, 07:51 AM
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Originally Posted by olsaltydog View Post
Thats what I am trying to figure out, NC pulled wind/hail a few years ago and require it to be separated. So that Insurance is through my primary homeowners but is a sub insurance through another group, NC Joint Underwriters Association. The crazy thing has been NCJUA hasnt handled any claims, there letting other companies do all the claims on their behalf and just paying for it. So I have the claim through NCJUA, being handled by State Farm, whose using Pilot for their field adjusters. The fella who is supposed to be coming today is from a completely different company that I will have to get written down when he arrives.

Its just frustrating, the adjuster coming has only said needs to measure the ridge vents and a room or two because of something.
If I were the adjuster here, I'd be so annoyed....not at you, but an examiner. Adjuster probably wrote to replace the ridge vent across the entire ridge line, but the examiner noticed on the photos that the ridge vent didn't go from end-to-end. Most likely the Pilot adjuster isn't getting reimbursed for mileage for the reinspection.
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Old 11-10-2018, 08:17 AM
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Be patient these catastrophes suck. My inside guys handle claims in every state. I just pulled them all off the hurricanes to focus on the wild fires as they come in. If you're still in the house it sounds like it isn't that bad. Be sure to mitigate your damages and they will get to you. I'd follow up every other week. You can file a dept of insurance complaint but I think it's a bit early for that. Typically when these claims come in those who are in an unlivable situation are handled first then the others. I literally get dozens of new claims per day per employee in these situations. Each takes about 5 hours of desk jockeying to complete while waiting for the outside guys to do their thing. I know it's excuses but it's just fact. If we double the work force we double the premiums and we all know how that would go.

If you need any help with the claim I'm happy to help. Please just keep it via PM.
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Old 11-10-2018, 09:03 AM
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Adjuster just left, he had a wierd accent so that is why I thought it was a whole new company but turns out he is for Pilot also.

Pretty much the issue was the previous adjuster "over scoped" my claim and left too much vague. Didn't put down ridge vents in paperwork but by picture they saw ridge vents. According to this guy the previous guy submitted things like rug, and other stuff that should not have been submitted by the reviewer and or him. So we will see how this song and dance goes.
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Old 11-10-2018, 09:12 AM
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Often adjusters are newly hired individuals who have recently become certified...many don't have any construction or insurance experience.
A few years ago I had hail damage on my home-called my insurance and they sent an adjuster out who looked all of 18 years old-if that. He spent about 5 minutes on my roof and said there was no hail damage. A year later, another bad hailstorm...another call...a different adjuster this time. After about 1/2 hour on the roof he came down and said there was considerable damage-including what looked like old damage. I told him about the earlier claim, and he said that adjuster missed damage that any experienced eye would see.
Get your agent involved.
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Old 11-10-2018, 09:52 AM
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Good luck dealing with them. It's now a year + after Irma damage to two of my homes in south fl. I even pat myself on the back for having "loss of income insurance" on my rental property in the Keys which lost income during this time. Guess what ? Not a penny after all this time and numerous adjusters and my claim adjusters, hired from the start turned me on to an attorney and we filed suit .
What a con job I have received.
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Old 11-10-2018, 10:16 AM
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I had two flood adjusters from Las Vegas and the wind adjuster was from Waynesville NC and all they tried to find everything they could. Flood is ACV for a non-primary residence but even after deductible the ACV should take care of everything. Same as the wind. The NC BEACH plan held back 25% and I might not be able to spend the ACV they sent already. Flood check within 5 days and wind check within 10 days. It all boils down to the quality of the "storm trooper" adjuster.

As said above, get your agent to get in the middle. That's what you pay him/her for. if it finally comes to it the NCDOI is very responsive and will rattle cages from the backside.
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