Already getting the insurance company runaround

[cottonmather0]

In January I paid to have two big water oaks trimmed in my front yard. Cost me $350 but the trees looked better and when the storm came through last week I didn't lose any limbs or branches bigger than a half inch. Nothing fell into the yard and nothing hit the house.

What did happen was that the wind pulled the gutters loose on the back of the house and caused them not to drain properly. The storm water falling on the roof flowed straight down into the flower beds that run along the back of the house. These beds didn't drain very fast because of a.) the duration of the storm and b.) the heavy rate at which the rain fell, and eventually the beds started filling up with water and water began to back up into the house through the weep holes in the brick.

We had about a half inch of water all through the back of the house and it drained almost as soon as the storm ended, but it ruined the wood floors and blistered and split a lot of the wood trim and cabinets in that part of the house. Probably about $10,000 worth of damage if I had to guess.

So today I met with the insurance adjuster and he said that we would probably get a new roof and trim and some new gutters to go along with it all, but that the water damage was caused by "surface water" and thus was excluded from the homeowners policy.... AND he made a call to his supervisor to confirm that there was not an official "flood event" in our neighborhood, so the flood policy wouldn't cover it either.

I asked, "So I would be better off if a tree had fallen through the roof?"

"Sure looks that way."

"Even if the wind damage caused the water damage, I have no sort of 'sequential causation' claim?"

"I am not allowed to make that judgment, sir. My advice is to call the main office and file an appeal."

I have naturally begun the appeal process with (name of major national insurance company in San Antonio), but right now I am P*SSED. If they don't cover this damage, then it comes out of pocket AND it doesn't count towards the deductible for the other damage that will need to be fixed. Here comes the runaround!

Unbelievable. And this is supposed to be a "good" insurance company that's supposedly worth the extra money they charge!

I should not have trimmed those trees.

[rsb320]

Scumbags! Really, the "San Antonio Company". I thought they just said ok and wrote a check.

[BryanS]

Hmmm... I know of only one major, really big insurance company in San Antonio... I also use them...

If a pipe bursts in your home, and does the same damage - no question - they have to cover it...

Because the water came from outside, to the inside - from the ground up... that's the gray area. To me, it seems to be a lot like the broken pipe case (and they would cover it)...

File the appeal with them... hopefully it will get to someone with some sense...

[Dan the Man]

Insurance companies are crooks.

[sifuwong]

In January I paid to have two big water oaks trimmed in my front yard. Cost me $350 but the trees looked better and when the storm came through last week I didn't lose any limbs or branches bigger than a half inch. Nothing fell into the yard and nothing hit the house.

What did happen was that the wind pulled the gutters loose on the back of the house and caused them not to drain properly. The storm water falling on the roof flowed straight down into the flower beds that run along the back of the house. These beds didn't drain very fast because of a.) the duration of the storm and b.) the heavy rate at which the rain fell, and eventually the beds started filling up with water and water began to back up into the house through the weep holes in the brick.

We had about a half inch of water all through the back of the house and it drained almost as soon as the storm ended, but it ruined the wood floors and blistered and split a lot of the wood trim and cabinets in that part of the house. Probably about $10,000 worth of damage if I had to guess.

So today I met with the insurance adjuster and he said that we would probably get a new roof and trim and some new gutters to go along with it all, but that the water damage was caused by "surface water" and thus was excluded from the homeowners policy.... AND he made a call to his supervisor to confirm that there was not an official "flood event" in our neighborhood, so the flood policy wouldn't cover it either.

I asked, "So I would be better off if a tree had fallen through the roof?"

"Sure looks that way."

"Even if the wind damage caused the water damage, I have no sort of 'sequential causation' claim?"

"I am not allowed to make that judgment, sir. My advice is to call the main office and file an appeal."

I have naturally begun the appeal process with (name of major national insurance company in San Antonio), but right now I am P*SSED. If they don't cover this damage, then it comes out of pocket AND it doesn't count towards the deductible for the other damage that will need to be fixed. Here comes the runaround!

Unbelievable. And this is supposed to be a "good" insurance company that's supposedly worth the extra money they charge!

I should not have trimmed those trees.

So which insurance company is this?

[crunchtastic]

USAA.

The days of USAA being special, different, and holding to a higher standard are long over. Their prime directive is holding on to their small and ever-shrinking niche market. Their overriding priority is to get you in deep with 6+ PPH (products per household).

I called in my roof damage on Sunday after the storm, have not yet had an adjuster come by, but by Tuesday had already gotten a form letter offering me all kinds of loans and credit cards and whatnot to help me get back on my feet after the storm.

[HtownWxBoy]

A condo I own and rent out suffered pretty good damage because the roof leaked... ruined a lot of walls and the ceiling and the carpet. Fortunately it's covered through the Home Owner's Association... part of the dues I pay goes towards insurance... this means they are taking care of everything from getting it fixed to dealing with the insurance stuff.... SUCH A BIG HELP! They began working like 2 days after the storm and are almost done already.... been so nice not having to worry about anything! The only stress I had was trying to deal w/ my tenant... but that was only the first few days... have not heard from her in a while thank goodness.

[travelguy_73]

A condo I own and rent out suffered pretty good damage because the roof leaked... ruined a lot of walls and the ceiling and the carpet. Fortunately it's covered through the Home Owner's Association... part of the dues I pay goes towards insurance... this means they are taking care of everything from getting it fixed to dealing with the insurance stuff.... SUCH A BIG HELP! They began working like 2 days after the storm and are almost done already.... been so nice not having to worry about anything! The only stress I had was trying to deal w/ my tenant... but that was only the first few days... have not heard from her in a while thank goodness.

Just because the HOA has insurance doesn't mean they (you) aren't going to get the runaround as well. It just means there are more people to spread the expense over .

We have received two form letters acknoledging our claim, but haven't actually heard from an adjuster. I am trying to be patient, since our damage is slight. Our neighbors house isn't even livable and they haven't had an adjuster out either.

eta: Just heard from an adjuster...yay, appointment for Friday!

[HtownWxBoy]

Just because the HOA has insurance doesn't mean they (you) aren't going to get the runaround as well. It just means there are more people to spread the expense over .

Well if they give my HOA the run around I really don't care... won't involve me... and like I said they are already working on the damage and will be finished soon... that's all I care about. I know early on right after the storm I received a letter from the HOA saying they have already begun working with the insurance people, so hopefully that means that's all going smoothly.

[CoolBuddy06]

Seriously guys I'm concerned. I used to think that homeowner's insurance cover all other damages except flood, so if you have both your home is ironclad. Shouldn't cotton's case be a pure homeowner's claim? What kind of policy covers that if homeowner doesn't?

[HtownWxBoy]

Seriously guys I'm concerned. I used to think that homeowner's insurance cover all other damages except flood, so if you have both your home is ironclad. Shouldn't cotton's case be a pure homeowner's claim? What kind of policy covers that if homeowner doesn't?

It is scary... I know I don't have flood insurance at my home in the Heights b/c I am up high enough... I did get scared, though, on Sunday morning when the heavy rain fell and the water started rising b/c all of the drains were blocked w/ leaves and branches. My boyfriend had to rescue me from my car at the CVS at Yale and 20th, 10 blocks from my house... I was coming home from work at 6am when the rain hit... almost lost my car... spent the morning getting soaked in the drains around our house trying to unclog them. I was thinking.... "I don't have flood insurance... what if this water keeps rising!?". Thank goodness the rain stopped and we unclogged the drains... water went down quickly.

Insurance should not be so difficult. If your home was damaged b/c of Hurricane Ike, insurance should cover it... plain and simple! I know it's not that plain and simple, I just think it should be!

[HtownWxBoy]

http://abclocal.go.com/ktrk/story?section=...&id=6393873

According to this article, you can apply for help from FEMA... it says the money can't be used to repair your home to it's condition before the Hurricane but it also says you can use the money for home repair... so I really don't know if they can help or not.

According to FEMA's site....

Repair: Money is available to homeowners to repair damage from the disaster to their primary residence that is not covered by insurance. The goal is to make the damaged home safe, sanitary, and functional.

[editor]

http://abclocal.go.com/ktrk/story?section=...&id=6393873

According to this article, you can apply for help from FEMA... it says the money can't be used to repair your home to it's condition before the Hurricane but it also says you can use the money for home repair... so I really don't know if they can help or not.

According to FEMA's site....

Repair: Money is available to homeowners to repair damage from the disaster to their primary residence that is not covered by insurance. The goal is to make the damaged home safe, sanitary, and functional.

Sounds like FEMA wants to help out people in a hard place, but doesn't want to play the role of gap insurer.

[HtownWxBoy]

Sounds like FEMA wants to help out people in a hard place, but doesn't want to play the role of gap insurer.

I think so too... the article saying they want to help out where insurance does not makes it a bit confusing... just something to look into.

[CoolBuddy06]

It is scary... I know I don't have flood insurance at my home in the Heights b/c I am up high enough... I did get scared, though, on Sunday morning when the heavy rain fell and the water started rising b/c all of the drains were blocked w/ leaves and branches. My boyfriend had to rescue me from my car at the CVS at Yale and 20th, 10 blocks from my house... I was coming home from work at 6am when the rain hit... almost lost my car... spent the morning getting soaked in the drains around our house trying to unclog them. I was thinking.... "I don't have flood insurance... what if this water keeps rising!?". Thank goodness the rain stopped and we unclogged the drains... water went down quickly.

Insurance should not be so difficult. If your home was damaged b/c of Hurricane Ike, insurance should cover it... plain and simple! I know it's not that plain and simple, I just think it should be!

It should be plain and simple. If not why do I fork out $$$ every January in the name of protection? I had no real damage right now, only the fence door just bite the dust, but what about the future? So is there some odd-name policies out there that covers cottonmather's loss?

[cottonmather0]

Today's update is that I spoke to a friend who lives down the street and who also has both flood and homeowners coverage from San Antonio Insurance.

Water also backed up into his house and and he says they told him the same thing - not covered by homeowners and probably not by flood, but call and make a flood claim anyway just to be sure. So he did and the flood adjuster showed up and said it was covered and he's now getting new carpet.

I put in a call last night to make the flood claim and the flood adjuster is supposed to call me soon to set up an appointment. We'll see what happens now but I am slightly more hopeful than I was yesterday.

[cottonmather0]

Well, we have been through the entire appeals process with USAA - three different adjusters have come to the house, each time a little less polite and a lot more to the point.

About three weeks ago we finally got a letter in the mail that our damages aren't covered and that the next appeal is with FEMA.

Apparently the applicable phrase is "wind driven rain." Well, YEAH, it was a freaking HURRICANE!!!

We wrote a letter telling USAA that they've just lost our car insurance, our flood insurance, homeowners insurance, and our savings account. A nice "member advocate" lady called to chat and said she would get back to us. She called 24 hours later and said to take it up with FEMA.

I told her, too, that USAA is losing all of our business and she said, "I'm so sorry to hear that. Let me know if there is anything I can do further to help."

If our damages were for more we would probably fight it out with them but it's not worth the cost of an attorney, to be honest. It's less that $10,000 worth of damage, but I am mad almost on principal at this point.

Anyway, if you have USAA right now and you are pleased, then good for you. We thought we were paying extra for good service and we were wrong. What's the point of having insurance if all they want to do is weasel out of living up to their obligations?

[Mr. Chenevert]

Well if they give my HOA the run around I really don't care... won't involve me... and like I said they are already working on the damage and will be finished soon... that's all I care about. I know early on right after the storm I received a letter from the HOA saying they have already begun working with the insurance people, so hopefully that means that's all going smoothly.

Be careful that you know what is really going on.

While the building has insurance, often times the deductible is huge. In the case of the Rise lofts in Midown, the deductible was $875,000.

Guess where that money comes from? That's right, all the owners of the units pay it based on the square footage of their unit.

Some of the larger units had to pay $10k even though their particular unit did not have any damage!

[crunchtastic]

Well, we have been through the entire appeals process with USAA - three different adjusters have come to the house, each time a little less polite and a lot more to the point.

About three weeks ago we finally got a letter in the mail that our damages aren't covered and that the next appeal is with FEMA.

Apparently the applicable phrase is "wind driven rain." Well, YEAH, it was a freaking HURRICANE!!!

Yea, thanks to all the post katrina lawsuits, everyone had that little addendum tacked on to their policies. The entire industry just frustrates me to no end. So far, USAA has even adjusted my claim upward, if you can believe it. But now I'm dealing with the mortgage company when it comes to actually drawing on the claim money. Just getting someone on the phone is like pulling teeth.

Regarding USAA, closing all your non-insurance accounts is the way to send a message if you are unhappy. (Granted, any other insurance co would probably deny the claim as well). As a direct provider, USAA's entire business model is based on getting you into as many non-insurance bank and investment products as possible. (I worked in the marketing machine there for 12 years). They are bleeding market share right now. If you cancel, you will be one of many thousands of data points in the post-Ike lost member powerpoint slide at the next management meeting in San Antonio. Not much, but at least your scream is going on the flight recorder, so to speak.

[travelguy_73]

Cotton, that is terrible and I really feel for you. Your story could be any of ours, and it is more luck than anything. I am not eligible for USAA, but before your story, would have jumped at the chance to be covered.

I guess we ended up pretty lucky. We had to replace our asbestos tile roof and two of three sides of fence. Nationwide's contractor adjuster came out within a couple of weeks, wrote it all up, and we had a settlement about a week later. And it was actually right on the money. They said they would have to make it payable to us and the mortgage company, but then they ended up just writing the check to us, which saved at least a week in delay.

We replaced the fence with our own labor to recoup some of the 2% deductible, M&M replaced the roof (very nice job), and all seems well. Of course, our insurance rates will go through that new roof next year, but we will all be in the same sinking boat at that point.

If it makes you feel any better, don't forget that you can tax deduct casualty losses denied by insurance. The threshold is pretty high, but at least you get something back.

http://www.irs.gov/taxtopics/tc515.html

[crunchtastic]

They said they would have to make it payable to us and the mortgage company, but then they ended up just writing the check to us, which saved at least a week in delay.

http://www.irs.gov/taxtopics/tc515.html

Wow, you got the check written out to just you? Everyone I'm talking to tells me that anything more than $5 grand is getting cut to the homeowner and the mortgagee. And it takes forever to handle the paperwork that goes along with all that. A week, I wish!

[cottonmather0]

Yea, thanks to all the post katrina lawsuits, everyone had that little addendum tacked on to their policies. The entire industry just frustrates me to no end. So far, USAA has even adjusted my claim upward, if you can believe it. But now I'm dealing with the mortgage company when it comes to actually drawing on the claim money. Just getting someone on the phone is like pulling teeth.

Regarding USAA, closing all your non-insurance accounts is the way to send a message if you are unhappy. (Granted, any other insurance co would probably deny the claim as well). As a direct provider, USAA's entire business model is based on getting you into as many non-insurance bank and investment products as possible. (I worked in the marketing machine there for 12 years). They are bleeding market share right now. If you cancel, you will be one of many thousands of data points in the post-Ike lost member powerpoint slide at the next management meeting in San Antonio. Not much, but at least your scream is going on the flight recorder, so to speak.

Yeah, that's why we're pulling out all of our money. They also played runaround with my wife on a car insurance claim earlier this year - the lady who hit her admitted in writing that it was her fault but since she was also a USAA customer they decided to split to baby and call it "equal responsibility." Again:

The hurricane damage was the icing on the cake, and then trying to pin the blame on FEMA and tell us not to be mad at USAA did not help. Well that's great that they say to take it up with FEMA, but we write the check to USAA every July and all three guys who came to my house had USAA ID tags on, so who else am I going to blame? Gene Norman?

Of course, we didn't hear from the "member advocate" until we told them we were leaving, so I know they got the message. The only problem is that I think the member advocate is less an advocate and more a sweet voice in an attempt to placate. Well, too bad. My house was hit by a FREAKING HURRICANE... it had never flooded before until it was hit by a FREAKING HURRICANE... and instead of being there and living up to their obligations the insurance company made up some excuse and said, "Na Na, we already got your money!" Well, bite me, USAA. I can earn the same amount of piddling interest at some other bank and still get my insurance denied by State Farm just as easily for a lot less money. Cheers.

[BryanS]

If water enters your house... from the ground up... wind or no wind... that's a flood. Sorry.

USAA is not a publicly traded company, thank God. They are beholden to their policy holders - not share holders.

Got money? Wanna keep your money? No Madoff money managers work for USAA.

People you can trust.

Our family has been with them for over 30 years. No complaints.

[travelguy_73]

Wow, you got the check written out to just you? Everyone I'm talking to tells me that anything more than $5 grand is getting cut to the homeowner and the mortgagee. And it takes forever to handle the paperwork that goes along with all that. A week, I wish!

Yes, it surprised us as well, and our payout was around $10k. I had even already contacted BofA to find out the procedure (send the check to Phoenix, wait, wait some more). I thought it was an oversight, but same thing happened with our neighbor and Nationwide, even after they told both of us that it would be a co-endorsement.

[spiderman]

Wow, you got the check written out to just you? Everyone I'm talking to tells me that anything more than $5 grand is getting cut to the homeowner and the mortgagee. And it takes forever to handle the paperwork that goes along with all that. A week, I wish!

It took about 10 days to get my insurance check for roof damage endorsed by Chase Mortgage and sent back to me - no paper work, I just attached a note with the check, included by mortgage account number, etc.

And I could have gotten it back sooner by enclosing a pre-paid express mail envelope.

[crunchtastic]

Wow. My mortgage is with USAA, as is my homeowners. My claim money is being held hostage. Lien waivers, signed contracts, inspections---these are the hoops USAA is putting me through in order to fix my house. They will absolutely not let you touch the money yourself. The money sits in escrow, then the payments are made in separate draws--endorsed to the freaking contractor!! It really pisses me off that I'm having to deal with this at all. If they're only going to pay what the contractor is going to charge, don't even bother sending the freaking checks to me. Don't make me sign 20 pages of crap. Handle it like auto insurance. Jeez. My goal is to get a new roof, not skim a few grand from my claim.