Policyholder Question: Frozen Pipe Burst Claim Dispute - Is it Time to Hire a Public Adjuster?

Policyholder Question: Frozen Pipe Burst Claim Dispute -  Is it Time to Hire a Public Adjuster?

Here is an insurance claim question that we answered as a contributing member of experts for United Policyholders who advocates for property owners.

Q. I had an upstairs pipe burst 1 month ago that caused damage to the upstairs bathroom (tile & drywall), carpet in upstairs (hallway & one bedroom), all of downstairs kitchen (walls, cabinets, ceiling, under-house insulation, HVAC ductwork). After quickly stopping the leak and vacuuming out the water, I set up my claim and started calling water damage restoration companies.  Of the dozen I called, only one could come out sooner than 5 days.  They began drying and demolishing within 2 days.  After my persistent calling, an adjuster finally got in touch with me 8 days later to setup an appointment.  This appointment was 24 days after initial damage!  Now I will talk about my dispute.  Two adjusters showed up.  The upstairs tile had expanded and contracted enough to bust loose.  The tile creaks badly and the adjusters bent down with me and clearly observed it moving.  However, they still were insistent on not replacing it.  I have continuous carpet (mended seamlessly at the thresholds) all over the upstairs including stairs.  They wanted to cut above the stairs and at thresholds, citing they only had to replace what was damaged.  Downstairs, they wouldn't even consider the tile, although I know that it was wet under those tiles for at least a week with plenty of time for mold spores to form.  Every piece of plywood under those tiles was wet and didn't get insulation removed for 4 days and never had a fan or dehumidifier put in the crawl space.

Where do I go from here? I thought I should first write the adjusters a letter in my defense.  I was an engineer for The Tile Council of North America which publishes industry-consensus guidelines for ceramic tile installation. I have plenty of expertise and sources to back my concerns. Or should I just get a public adjuster? Thank you!


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The Big Freeze Broken Pipes and Snow… the Way It Was

While looking for some information in my office library yesterday, I pulled a book from a shelf titled The Policyholder Advisor authored by Eugene R. Anderson, William G. Passannante, and Robert M. Horkovich. These three gentlemen, all attorneys, and at the time of publishing in 2002, shareholders at Anderson Kill & Olick P.C. now Anderson Kill P.C. one of the nation’s leading law firms for policyholders. The book jacket noted that the book is a collection of articles published in the firm’s newsletter, “The Policyholder Advisor.”

It was a little uncanny when I opened the book, and it opened to page 181 and the chapter title was “Insurance Coverage Available for Property Losses from The Blizzard of 96.” While no two storms are ever the same, there sure are a lot of similarities between the 1996 blizzard and the current polar vortex malaise of 2014; especially when it comes to insurance coverage issues and disputes with insurance carriers.


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Frozen Pipes, the Resulting Water Damage, and Now Snow--Is It Time to Call in the Cavalry?

Frozen Pipes, the Resulting Water Damage, and Now Snow--Is It Time to Call in the Cavalry?
With another polar blast and big snowstorm adding to the misery in the already frozen Northeastern U.S., I was wondering how the property insurance industry is holding up given the onslaught of property claims being filed. Well, that question was answered when we received an auto-reply from an adjuster in New York who works for one of the big insurance companies who we are working with on a claim following Super Storm Sandy. His reply, “please be advised that we are currently experiencing higher than normal volume due to recent weather related events and there may be a delay in returning your email.” Returning timely emails is one thing, but adjusting a loss is a whole other animal given the working conditions in the frozen north; especially when it comes to frozen pipes.
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Policyholder Question: What’s Covered in a Pipe Leak Water Damage Claim?

Q. I have filed a claim for water damage to my living room. The adjuster provided details of coverage prior to mitigation, for $1, 762.68 including my $1,000 deductible; for which I paid. The mitigation folks provided another estimate of an additional $6,000 to my insurance adjuster. This was their estimate once they opened up the wall where the water was causing damage. Two major findings, once they opened up the wall: 1) they discovered a pipe leak 2) two beams are termite infested! Neither are covered under my insurance (Nationwide)! The company that came in to do the recovery completed the cleaning, disinfecting, and drying out process. However, they informed me that they would not replace the wood beams that are damaged by termites. I paid for the restoration of the pipe out-of-pocket but cannot afford to pay anymore additional repairs. I explained this to them; to which they replied, "you can cash out and get another estimate." I told them that I needed to get further guidance. They said they would get back to me and left. I have not heard from them, and now I have one wall and part of the floor in my living room exposed. What are my options?
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Policyholder Question: Water Damage Claim and the Restoration Company’s Cleanup Bill, Who Pays & How Do You Get It Paid?

Q. I had water damage in my house due to an over flowing toilet. My insurance company said it would pay $8,000 to the restoration company that did the clean-up. The problem is that the restoration company who did the water extraction sent me a bill for $36,000. The insurance company sent me a check for $8,050.  Should I mediate or go the appraisal route?
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"On Property" Insurance Claim Tips Blog

Tips and advice about how to properly file and protect your property damage insurance claim and get a fair settlement. We invite all readers to ask questions about their claim so our public adjusters can post answers for others to benefit. Insurance claim expert guest bloggers welcome to submit posts via our contact form.

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Tutwiler & Associates Public Adjusters, Inc.
Licensed Public Insurance Adjusters & Loss Consultants
Offices: Tampa, Orlando, Palm City, Ft. Myers, Florida; Dallas, TX; Pittsburgh, PA

Executive Office
4300 W. Cypress St.
Suite 780
Tampa, FL 33607
Phone: 813.287.8090
Toll Free: 800.321.4488

Licensed in Florida # W840088 &
Texas #1399706 plus 16 other states
and the Virgin Islands