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A Long Story to Make a Short Point
A story of an insurance nightmare, by insurance customer advocate & author Ron Alford
"About two months ago, my husband, an electronics engineer, was working on a 3 month project in England so I decided to visit a relative over the weekend. When I returned home on Sunday night around 9:00 PM, I found that my living room, dining room and hallway were covered with about 2 inches of water.
Panicked, I ran to the neighbor for help and he shut off the water mains. In a few minutes, my neighbor told me that my dishwasher hose was the culprit. It broke and caused water to be everywhere. Everything was soaking wet and the smell was awful.
Not knowing what to do and fearing that this event was going to cost a lot of money, I tried to call my insurance agent only to find that the water had disabled the phone line. On top of everything else, my telephone did not work. No sense calling my husband, he was in England where it was 3 AM.
When I tried to call my insurance agent from my neighbor’s house, all I got was a recording. My house was stinking of mold and mildew so I knew I could not stay home. I didn’t feel comfortable crashing at my neighbors for many reasons so I decided to spend the night in a local hotel.
The next morning, I got in touch with my Agent and he told me that he would report my claim to the insurance company for processing. When I asked him questions about what was covered and to recommend a plumber to fix the hose on my dishwasher, my agent told me that my policy did not cover the cost to fix the broken plumbing. I thought, OK, if this is the first thing that is not covered, what else can I expect to happen? I had been his company’s customer for 18 years and during this time I don’t recall hearing anything from the agent about what was NOT covered.
The words I remember hearing the agent tell me and my husband were things like; God forbid, if an airplane part falls from the sky and damages your house, "You’re Covered!" Now, you would think that if damage from objects falling from the sky are covered, then replacing a hose connection would be covered! But it is not.
All of a sudden, it dawned on me that I did not have a clue on what was covered and what was not. To make matters worse, it was becoming apparent that my Good Neighbor insurance agent was not going to be any help either. To the contrary, the help and advice I had expected was not forthcoming. His words were, I have nothing to do with claims of this size and you have to wait for the company’s adjusters to appraise your damage and they will also interpret the coverage. What does he mean, interpret my coverage?
When I finally reached my husband on the telephone, we decided that since he could not return for at least eight weeks, I would be forced to take time off from work to manage this water damage problem. Little did we realize at the time, how much lost time, aggravation and grief I would have to endure to learn what every consumer should learn before they buy any insurance.
You can bet that the next agent that gets a premium from me will earn it.
She looked at me with despair, and said "Here I am and it is over two months later and the good neighbor insurance company is still demanding that I produce things that they know are almost impossible to find. The truth is that they are treating me as if I am a criminal who is out to cheat them.
The reason I am in your store today is the floor covering company I purchased my wall to wall carpet and draperies from is out business. I am not the kind of person who keeps cancelled checks and I don’t like clutter so receipts don’t last any longer than the warranty.
A little over 3 years ago, I paid around $4,300 for my wall to wall carpets and another $3,500 for matching floor to ceiling draperies. I can prove its age with photographs, which were taken by a friend a birthday party I gave her at my home thirty eight months ago. The photos show the old carpets on the floor and the old drapes on the walls. In spite of this documentation, the insurance company's adjuster tells me that she thinks that these articles appear to be much older than that and that this photograph could have been taken in another house so she wants to see proof of date of purchase and the amounts so that she can depreciate the value of my loss.
The adjuster is also the person who told me:
• That the hotel I stayed in was far too expensive.
• That if I left all of the doors and windows opened, all the mildew smell in my home would disappear.
• That my waterlogged furniture can be restored with a little furniture polish.
• That I should wash my mildew-damaged clothing at a local Laundromat.
• And a myriad of other bits of information and advice that only benefit the insurance company, not me.
Every day I have called my insurance agent to expedite this mess and to see what clout he had with the insurance company. So far, what I've gotten is no help, conflicting stories and just plain biased information. For example, at the outset of this claim, the agent told me to do one thing, yet eight days later the adjuster told me something else. Listen to this gem of misinformation.
Example of Bad Advice
The first day I called my insurance agent to find out what I needed to do to manage this mess and learn how to go about making an insurance claim, the agent told me not to do anything until the company’s adjuster has an opportunity to review the damage. It took six working days before the adjuster arrived and the first question she asked (while she recorded our conversation with a hand held tape recorder) was "Why didn’t you take the necessary steps to have your home and contents dried out?"
When I told her that my instructions from the agent were to "wait until you arrived" she told me that she didn’t think that her supervisor was going to pay the full amount on this claim because I did not keep my end of the contract. She asked me, "Didn't you ever read your insurance contract?" Then she pulled out a copy of my "super deluxe it covers everything homeowner’s insurance policy" where she pointed to a section that said, "the duties of the insured in case loss occurs." She read me the section.
I told her that she sounded like a lawyer and she said, "I am." When she said that, I almost fell through the floor. I found out that this insurance company regularly hires adjusters who are inexperienced lawyers fresh out of law school because they are affordable trained adversaries. Their main concern is to protect the insurance company’s interest at all times.
"So, there you have it" she said to me. This is why I am in your floor covering store looking to buy a receipt so I can get out of this mess and get my life and home back to normal. I can’t begin to tell you how this experience has moved me from being an honest and trusting consumer to coming in here and try to buy a receipt, which I realize is fraud. The only reason I am doing this is that this insurance company, its agent and adjusters has failed miserably to deliver reasonable expectations. To the contrary, my experience is that they have defrauded me and as well as every other person who will file a claim because of their actions and inaction’s.
Today, I am rationalizing that if they can abuse me, it is OK with me to give them a phony receipt. This makes me sick. This normally rational woman then broke down and she started to cry uncontrollably.
The rest is history. When she got herself under control, I told her that this was her lucky day and that I wouldn’t give her a receipt but I would show her exactly what she needed to do in order to get exactly what she was entitled to from her insurance company.
I did and she recovered both physically and financially before her husband came back home from England.