Persistence Pays
It’s been a while since we updated the blog, and we’re trying to get back into the habit. I wanted to touch on a topic I try to provide to all of our clients.
The old adage goes “Good things come to those who wait.” But, with what we do, it’s more than waiting. You have to persist.
Insurance companies are at an inherent advantage from the minute an insured has to report a claim. The insurance industry has drafted the insurance contracts, and gradually changed the forms over time to be more favorable to its profits. They’ve lobbied to try to get the law on their side. They’ve appealed to try to create case law in their favor. And that’s all before the claim happens.
On top of all that, your first thought isn’t “the process.” It’s stopping the problem. Calling a plumber. Calling an electrician. Calling a roofer. Whatever type of claim you have to make, you have to make sure that it’s not still happening.
You have to protect the property. Fans. Dry the property out. Clean up water. Move debris. Make sure the property is safe to be in. Can you stay there overnight? Medium term? Is it a health risk? Did you save the failed part or component to show your insurance company? No? You weren’t thinking about it at the time? We don’t blame you. All these things are happening simultaneously in a big jumbled mess.
There’s a lot going on, and you have to deal with all of it before you even start thinking about getting that first dollar of reimbursement.
You’re at a disadvantage because you had more than one thing to think about and the insurance company knows it.
Once the dust settles (both literally and figuratively) and the insurance process begins to wear on, you have to start to balance things. You need to make those temporary repairs to protect the property, but you have to hold off on the permanent repairs because the insurance company needs to see them. Then they need to see them again. And maybe again. Or an engineer.
Each time the insurance company does something, a new timeframe kicks in.
There’s no set timeline for how long a claim can take.
Fla. Stat. 627.70131 says an initial coverage decision and undisputed payment should be made within 90 days. Some companies wait until day 89. Some are faster. While others go over the deadline and send you a vague letter that says they’re still investigating.
After that, everything generally moves in 30 day increments. 30 days to review an estimate and respond with a POL is a set timeframe, although they can take longer if they send that vague letter again.
Most other things move in 30 day increments just as a rule of thumb. Setting up an inspection should happen within 30 days. A report following an inspection should be finished within 30 days. The desk adjuster should review and respond within 30 days. Sometimes it requires management approval.
With all these moving parts, delays can compound and it can be 6 months or a year post-claim before you know it. All the while you’re living with damage and your home ripped apart, or worse yet, unlivable.
This can create the ultimate advantage for your insurance company. Desperation.
If you can’t take it anymore, you might be tempted to slap together whatever duct tape and band-aid repair you can just to be done with it. If you do that, you might compromise your claim. If you get desperate, please, call us before you do anything.
If the insurance company employs this strategy on your claim, the best outcomes are the ones that stick it out until there’s an agreement. It’s hard to fathom up-front, but this should be something that you’ve prepared for early on in your claim.
If you aren’t immediately prepared to wait as long as it might take, you have to have a short term, intermediate term, and a long term plan in place to make sure you’re fairly paid.
In the short term, you should plan to make repairs to protect the property and prevent further damage, and if your home is unlivable, you should have arrangements for temporary housing.
If your claim takes 6 months or more, you should have an intermediate plan that includes more temporary repairs if your insurance company hasn’t paid you. This can be anywhere from making your home livable, like making sure there’s running water and functioning sanitary/waste, to making sure electrical is working safe. If you can get back in your home, even if there are missing walls, carpets, floors, etc, it will impact your bottom line when the time comes to settle.
If your claim is denied or you have to file a lawsuit, you might need to be ready for the long haul. There’s no telling how long it can take at that point, but again, persistence pays. You either have to be mentally prepared to live long term with the intermediate plan, or if your home is still unlivable, a plan in place for long term housing (with your policy’s limits probably coming into play, creating additional leverage for the insurance company).
In the alternative, if you haven’t been paid enough, you might need to consider funding permanent repairs out of pocket, or through alternative financing if you truly can’t take it. This can create new sets of issues, as well, since it can cap your insurance recovery at the amount you paid (if you’ve truly done ALL the repairs), and can allow the insurance company to shift its defense to claim that you’ve “improved” the property. Your insurance is meant to restore you to pre-loss conditions, which includes replacing things with “like kind and quality.” The overwhelming majority of our clients only want that type of restoration, but many times, if you replace a 20 year old middle grade cabinet with a new middle grade cabinet, the more modern design makes it look newer, which gives the insurance company this argument. This type of decision is entirely up to the homeowner, but those types of impacts are what need to be considered to make an informed decision.
There are a lot of different routes an insurance claim can take, and they all reach an eventual conclusion, but those willing to jump through the hoops are the ones that usually end up in the best position when it comes time to repair.
We cannot stress enough that the worst claim outcomes are the ones where someone gets so frustrated with the process that they decide, instead of calling us to discuss, they’re going to just get a family friend or day laborer in to slap together some repair, and at that point, they may have already shot themselves in the foot.
If you find yourself in this position, please call or email our office to discuss your options moving forward.
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Persistence is necessary in dealing with your mortgage company once you have your claim check
The problem with the "Elephant" in the room.
Under Fla. Stat. 627.70131 and 626.9541(1)(i)4. your insurance company has an obligation to pay or deny your claim within 90 days of receiving notice. So what do you do if your insurance company's specialty is delaying claims? What happens when the 90 days expires?
Honestly? Nothing.
Your adjuster can't hold the insurance company's representative upside down and shake them until change falls out of their pocket.
You can hire an attorney, but if they know what they're doing, they'll know that the same statute says violation of the "90 day provision" doesn't form the sole basis of a cause of action. You can't just file a lawsuit because things are slow. Your insurance policy doesn't say they have 90 days to pay and in order to file a lawsuit, the insurance company must have breached the contract.
The remedy for an insurer taking longer than 90 days is technically for them to pay interest on whatever payment they issue.
Many insurance companies sit on claims and wait for day 89 to send you a request for additional information, which legally buys them 30 days, and then they can keep kicking the can down the road every 29 days repeating this indefinitely.
So what are you supposed to do?
Hire someone who puts actual effort into your claim. You need to present your insurance company your damages and provide all reasonable documentation they request. Then, your representation, be it attorney or adjuster needs to document follow ups. Send letters and emails. Keep logs of phone calls.
If you've created a paper trail showing you've given the insurance company everything they need to make a decision, and they've repeatedly blown you off when you're putting in a reasonable effort to adjust and resolve your claim, and you still make it past 90 days, then you can hire an attorney who can file a lawsuit on the 91st day, with an entitlement to attorney's fees and costs that are in addition to your claim, and it will get your claim out of the hands of the department that don't have the time for your claim or are making the conscious decision to ignore it.
If you’ve made a claim for property damage with Universal Property Insurance Company in St Lucie County, give VIP Adjusting a call today at 772-600-4663 for a free claim review.
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