Q. We moved into our new house and within a few weeks, the sewer backed up into the shower and leaked out of the shower pan all over the downstairs area (very stinky!). Everyone agrees this is considered a "Category 3" leak. Remediation company came and took out the tile, flooring, a lot of drywall and dried everything out. Insurance company has no problem paying them for everything they did (they seem to work together a lot). Insurance adjuster is saying that the tile and shower pan are part of the plumbing and are not covered, but is saying that they will pay for the cement board behind the tile in the shower. They are also only planning to pay an amount roughly equal to the cost of the remediation for reconstruction (which is roughly equal to the estimate from the remediation company....because they provide reconstruction services as well). It seems ludicrous that reconstruction would cost the same as remediation. To rip stuff out and dry it out is a lower level of skill and doesn't require any materials.....but the adjuster is saying we are lucky that he is covering what he is covering. The remediation company isn't even available to do the job. We have 3 bids from other quality contractors that actually have availability and they are double the price.

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One of the things I like about blogging, is that the tips and advice you provide policyholders about issues they are having with their insurance claims stays up indefinitely and can assist people having the same claim problems. I recently responded to reader question from a 2013 guest blog post on the Merlin Law Group Property Insurance Coverage Law Blog that I had the privilege of contributing to. The article titled: Insurance Companies Using Preferred Contractors to Settle Claims Not in Policyholders Best Interest discussed how insurance companies send out their preferred vendors who then try to control costs to the consternation of the policyholder.

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Those who experienced any type of property damage from the severe hurricanes and file claims early are starting to hear back from their insurance company. Many will learn that the claim settlement amount(s) being offered are not sufficient to pay for their complete loss and damages. Specifically, as the demand for qualified construction workers, roofers, and building materials increase, so do the associated costs. This “supply and demand effect” will undoubtedly continue to impact those who sustained damage in a negative way for some time. 

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Non-weather related water loss insurance claims in Florida are on the rise. So says Chief Financial Officer Jeff Atwater who heads up the Florida Department of Financial Services. The problem is so great that his Florida Consumer Advocate, Ms. Sha’ Ron James called for a summit and invited all stakeholders to attend. 

Mr. Atwater is not the only one sounding the alarm on water damage claim issues and its companion Assignment of Benefits (AOB). Based on my following the news on this hot topic it seems most insurance carriers in Dade, Broward and Palm Beach county areas are all in agreement that the situation is getting out of control and in fact may be critical, requiring rate increases and further reductions in insurance property policy coverages for water losses.

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First I want to share some atmospheric observations and conditions that are clearly changing in the Caribbean and may play into the El Niño, La Niña narrative. On my trip last week to the Leeward Island of St Maarten I had the opportunity to visit with old clients, friends and observe changes that have occurred since my last trip in 2015. 
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The following is a short primer and history lesson for the insured property consumer on these two fool’s errands. For those of us in the property insurance adjusting business, we see the storm clouds gathering given all the recent rhetoric about allowing a policyholder’s insurance company to repair their property following a covered loss.  Given our knowledge and experience, we know the likely outcome of this latest scheme to pump up underwriting profits, but my guess is not many laymen do.  Make no mistake about it, your policy premiums will not drop if these managed repair programs being touted as a savior for you and the insurance industry is approved by the Tallahassee regulators. The irony is that managed repair and its stepchild “option to repair” will most likely be bad for both the insured and the insurer. So given what may be the inevitable, let’s examine both of these repair schemes. 

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Insurance companies have started exercising their options to repair under many of their contracts. What this means is that they are bringing in contractors of their choice to fix the damages resulting from a property loss they cover. Let’s be honest.  They have a right to do this, but it often isn’t in the best interest of their customers when they choose to do so. Why?
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A great deal of information is being published regarding some insurance companies’ plans to implement so called “Managed Repair” programs. The rationale is that they will reduce costs (and I assume increase profits) by partnering with restoration contractors and some independent adjusting companies who supposedly will oversee the work and provide some sort of due diligence. This will lead to the latest scheme being proposed to a reduction in the cost of insurance premiums. So the most important questions we should be asking are: What’s the real cost to the policyholder and will rate increases continue despite these managed repair programs?

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For as long as I can remember, property policies had language that allowed insurance carriers to exercise their “right to repair” the policyholder’s property. There was always a catch for some of the insurers since there was generally a requirement that they had to give the policyholder 30 days notice after they received a proof of loss. Some policies may have had slightly different language, but for the most part if they missed a deadline date, they were out of luck.

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The public insurance adjusters at Tutwiler & Associates work extremely hard to prove why our industry profession is so valuable to policyholders. We work with potential clients and share our knowledge to guide them in their property insurance claim decision making. We strive to educate policyholders after a serious loss when they are the most vulnerable.  Case in point involves a massive electrical fire that occurred at a Sarasota condominium last August.
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