My parents applied dozens – if not, hundreds – of times for insurance for my baby sister who would die without another heart operation, but were turned down everywhere they went. My mom, a teacher, was even turned down at job interviews because schools feared that their insurance premiums would go up. My dad, a contractor who was proud to finally have his own construction company, had to give it up and join the Local 401 Philadelphia Ironworkers Union in order for my sister to get insurance coverage.
That was back in 1990. Now, 24 years later, I work with a company that acts an advocates for consumers against their insurance companies. ACI Adjustment Group, ranked #1 in Customer Service in PA & NJ by the United Public Adjusters Association (UPA) has a brief explanation for this shameful phenomenon.
An elderly woman in Seaside Heights, New Jersey suffered damage to her home as a result of a sink hole - a covered loss under her policy. The home collapsed inward causing significant damage. It was a total loss. Her foundation was ruined, mold growth was everywhere, and one end of the upstairs hallway was about 6 inches above the other end of the upstairs hallway. The home was deemed unlivable and the elderly woman was left without a home.
The insurance company sent out an engineer to evaluate the damage. After a 12-minute inspection, the engineer determined that the foundation crack could be "glued together" and the structural damage could be corrected with basic rebar re-inforcement. The total payout: a little more than $30,000.
How did an atrocity like this happen? It turns out gross underpayment of claims is not uncommon at all. In fact, it's a growing epidemic.
Most insurance companies, including this one, sent insurance adjusters from out of state to handle Hurricane Sandy claims. The company adjusters and independent adjusters who were hired by the insurance companies had absolutely no interest invested in the towns that were affected, were living away from their home for weeks at time, and were paid many times based on how many claims they did - which enticed many of them to work as many claims as they could fit into a day - hence the 12-minute inspection for the poor elderly woman who was left homeless.
Many insurance companies decided to hold their employed adjusters personally liable should more funds be released to a paying client than the insurance company deemed fit to restore the damage, causing many adjusters to be extremely conservative in their payouts, hence the $30,000 offer for a total property loss.
Fortunately, there are Public Adjusting companies like ACI Adjustment Group, who assist homeowners in recovering settlements that are fair to them. Public Adjusters work for the paying policyholder, not the insurance company. They negotiate on behalf of home and business owners with their insurance companies to ensure a fair settlement.
Not only do most homeowners not know that such services exist, but most homeowners don't know what they're covered for in their policy. Anytime an insurance company adjuster pays for a "patch job," that homeowner should seek professional help. Most policies cover for full replacement cost, and there is a term in the policy called "indemnity" that means restoring or reimbursing one to the full extent of their loss. This means that if damage occurs to a homeowner's roof, such as ice damming or a tree falling down, the insurance company covers for the replacement of the roof.
Why? Because the function, appearance, and value of that roof must be restored. Damaged insulation leads to higher heating and air conditioning bills. Warped sheathing makes the roof appear to be collapsing inward or bubbling. When a shingle is removed from a roof, a tar seal is broken that is nearly impossible to replicate by just replacing the shingle. A patch job on shingles sticks out like a sore thumb and is a red flag for damage. When that homeowner decides to sell their home, the buyer's real estate agent will use the mismatched shingles as negotiating leverage to devalue the home by the amount of roof replacement or request that the roof be replaced in order to keep the same price. A new roof really is the only feasible solution when roof damage occurs, as the roof is the most important piece of armor that protects the home from outside elements.
There are two sides to every story, and just as most people wouldn't go to court without an attorney, property owners shouldn't pursue an insurance claim without a Public Adjuster.
Insurance contracts are written in favor of the insurance companies, placing the "burden of proof" on the homeowner. In other words, the property owner must prove that their damage occurred as a result of a covered loss, and that the scope of damages (the amount of re-construction needed) is covered. Public Adjusters, like those at ACI Adjustment Group, are well-versed experts on insurance policies. A Public Adjuster has experience negotiating on behalf of homeowners to ensure full compensation and protecting homeowners from being low-balled by their insurance company.
The bottom line is that with the recent increase in severe weather, property owners are more likely to suffer damage to their property, and more likely to find out why the rest of us hate our insurance company. (Whenever a homeowner says, "I've never had a problem with my insurance company," the first question I ask is, "Have you ever put in a claim?")
The ACI Adjustment Group team has several industry experts with inside information about how the claim process works. Many of our adjusters worked for the insurance companies, including Dennis Langford, who was the lead Project Engineer in the Meridian Plaza fire that destroyed a large high-rise office building in Center-City, Philadelphia. Many of these adjusters have switched teams and joined our firm because they wanted to stick up for the average consumer, who always seems to be getting screwed.
People need to know about the services of Public Adjusters. Our industry has been silenced by the insurance companies and their lobbyists for too long. Word needs to get out and we hope that you will assist us in spreading the word!