Frequently Asked Questions (FAQ) – Insurance Claims & Property Damage
This page provides answers to frequently asked questions concerning Filing a Claim with your Insurance Provider, what to expect and when to expect it. If you don’t see the answer to your question here, please Contact Us, and we will respond as soon as possible.
If your home has been damaged or destroyed, you are likely to feel overwhelmed by the loss and by the repair, replace, and recovery process that lies ahead. Providing your property was properly insured, then your insurance policy is the best road to get you back home. If this is your first large insurance claim, realize that it is a business negotiation – between you and your insurance provider.
When it comes to insurance terminology (laws and construction estimating, etc.)…you are not playing on a level field with your rival, the experienced insurance company. You are most likely unfamiliar with your policy and the process in general, however, there are rules and laws to protect your rights – rights which must be used to negotiate and recover the full benefits which you are entitled to under the policy which you have paid good money for.
Begin by reading your policy’s page entitled “declarations”, it will tell you how your policy’s coverage is divided into what categories: Dwelling – coverage A, Other Structures – coverage B, Personal Property – coverage C, Loss of Use/Additional Living Expenses – coverage D. By this point you should have a basic understanding of what’s in your policy and what is covered.
Next, you will need to figure out how much you are entitled to be paid for dwelling repairs or replacement, debris and tree removal, and building code compliances. This is where construction estimating comes into play. Do not rely only upon your insurance company adjuster to calculate your scope of loss for you – you will be leaving your hard-earned money on the table.
If like many, you don’t believe you can properly account for your losses on your own, (and many can’t), you should consider contacting an experienced and reputable advocate such as a licensed building contractor, policyholder lawyer, or public adjuster.
Proving an insurance loss is the responsibility of the insured. You will need to document as much of the damage as possible; this should not only include all recent related damages but also include any pre-loss evidence you can gather showing the condition before the event occurred to help demonstrate the extent of your loss, pre-existing vs. event-related damages.
Take Photos and Video – all current damage of your home’s interior and exterior. Look for any pre-existing photos you may have taken in the recent past which can be used for “before and after” purposes. The carrier will not be able to claim the damage was pre-existing or normal wear and tear.”
Document The Damage – Keep track, and make duplicate copies of all estimates and receipts. Also, prepare a detailed inventory of all damaged possessions, with their approximate age, initial price, and estimated cost to replace.
Make Temporary Repairs – Don’t wait for the insurance adjuster to start making temporary repairs. Broken windows and leaking roofs should be fixed or tarped immediately so the insurance company can’t dismiss any claims as to the result of waiting too long to do act. Again, save all receipts and documentation and the insurer will most likely reimburse these expenses.
Insurance companies often write their policies with a bias in their own favor. Do not accept an insurance company’s calculation of what they owe you for your claim without getting other opinions.
You paid good, hard-earned money for your insurance benefits. If you feel that you’re in over your head, hire qualified professional help. Depending on your particular situation, a licensed construction professional, policyholder attorney or reputable public adjuster can make a huge difference in getting your home back to its pre-loss condition without further delays and aggravation.
On average, most claims are fully processed (from open to close) between 3-6 months. However, this process can differ from one insurance company to another and may also vary depending upon the scope of loss.
- Not having enough coverage (being “underinsured”)
- Confusion over what’s covered and what’s not
- Insurance Company “Lowball” estimates and settlement offers
- The insurance adjuster assigned to the claim is difficult to work with
- Differences in opinion over scopes and values of losses
No. Flood coverage is provided through the National Flood Insurance Program. This type of insurance would be purchased as a separate policy through your insurance provider.
Please note, not all Water-related damages are the result of “Flood” events. The truth is that most insurance policies cover most types of water damage, but they exclude damage caused by “flood”. Many insurers will deny claims for water damage simply by claiming the damage was due to flood – this is most often in response to the policyholders initial reporting of the event to their insurance company as a “flood”, i.e. “my basement is Flooded”, instead of “my basement is filled with water, I need it fixed”.
Though your insurance adjuster might be friendly, he or she is not your friend. Remember, insurance companies are profit-making businesses, and settling a large insurance claim is a business deal. The more you understand the process, the better you’ll do.
Insurance companies will naturally attempt to limit their payouts, as for-profit businesses insurance company contracts are often riddled with confusing and obscure wording and legalese which helps them do just that. Again, if you feel you are not up to this task, it is recommended that you hire a professional advocate who is familiar with the state laws and regulations established to protect your rights.
Most often the homeowner is responsible for the clearing of debris. However, if your home was damaged or destroyed in a widespread catastrophic disaster, your local government officials may have established a debris removal program.
No. Many claims go relatively smooth and we hope yours does too. But every large loss insurance claim takes time to negotiate and process.
Generally speaking, no. Your insurer owes to restore your property to its pre-loss condition subject to the dollar limits of your coverage. The appearance of your home after repairs have been completed should be uniform and consistent throughout. If you did not have two different colors of siding prior to the loss, you shouldn’t have to have them after.
Computers don’t repair and build homes…licensed contractors do. Your insurance company owes you the amount that an experienced and reputable contractor would charge you to put your home back to its pre-loss condition. Insurance companies use guideline pricing and “Xactimate” (a home replacement cost estimating software package) to “predict” or “estimate” how much the materials and labor cost should be. But an estimate prepared by a qualified, licensed, and bonded contractor who has visited the loss site and reviewed information about the pre-loss structure is generally the most reliable basis for a claim settlement. Remember this is just an “Estimate”, whereby “budgetary” costs are established and is not the time to settle your claim.
Phase III Construction utilizes the same guideline pricing and software as the insurance industry to account for and process your complete scope of loss. We will prepare a thorough, “firm” scope of loss which will include any, and all supplemental additions, “supplements”, which may be overlooked or omitted by your insurance company adjuster. As your choice expert representative and advocate, we make certain to account for everything to make you and your home whole again.
No. Policyholders should not fear their insurer dropping them or raising rates if they challenge a payout. They simply will not drop you because of a claim. However, they will drop you if you are a risk to them, for example, if they were to find out that you are storing propane tanks in the house or you have exposed wiring.
As for premium rate increases, this is determined by the nature of the claim, not the cost of recovery.
Actual Cash Value coverage reimburses you for the cost of the lost or damaged item minus depreciation. So, if a fire destroys your 10-year-old TV, you are reimbursed for the value of a 10-year-old TV. Replacement Cost Value coverage reimburses you for the cost to buy a new TV.
Replacement Cost Value coverage is pricier than Actual Cash Value coverage, but you will be glad to have it if you ever lose everything in a disaster.
Overhead and Profit, or O&P is a known expense that all contractors charge. It is intended to cover the overhead / operating costs of a general contractor as well as the amount of profit that the general contractor typically receives, usually at a rate of 10% (overhead costs) and 10% (profit) which is added to the scope of loss.
As a rule of thumb, nearly all insurance providers will not hesitate to pay O&P when the project’s scope of loss requires the application of three (3) or more separate trade entities; whereby the complexity of the project necessitates a skilled management of all labor and material deliverables to properly execute the entire project scope.
It is typically dependent upon the extent of the damage, however, in most cases we would highly recommend getting professional assistance. Flood water often seeps into areas behind walls that you may overlook, which could result in mold and other problems as a result. Give us a call today for a free estimate.
As a General Contractor, we have worked the ranks of sub-contract tradesmen ourselves and have acquired our master-builder licensing in all applicable trades of residential and commercial building and development. This equates to total quality oversight of the entire scope of your project from start to finish; as master-tradesmen, we will ensure the successful application of only the BEST in quality trades and materials to fully restore your home to its pre-loss condition. In addition, we have the knowledge and experience to accurately represent your best interests, as your Advocate when it comes time to negotiate your insurance claim settlement.