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Ron Lieber: How to manage homeowner's claims

Sunday, Nov. 11, 2012 | 12:34 AM

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There is a sort of honeymoon period that occurs after a big storm like Hurricane Sandy, when insurance executives appear on the local news offering reassuring words.

Their vans pull into residential neighborhoods amid the standing water and debris. Everyone is hopeful. Handshakes and back-patting all around.

That period is about to end. Many victims of Hurricane Sandy are novices when it comes to catastrophic insurance claims. So to see what sort of resistance they should expect shortly, I turned to the lawyers and adjusters-for-hire who do nothing but negotiate with insurance companies all day long. Some of them used to work for the companies, in fact.

Here are the things they warn people to watch out for:

Independent adjusters

Many people with damaged homes have started to meet with representatives who assessed their damaged homes to estimate repair costs. They may have introduced themselves as "independent adjusters," but this is a misnomer. They represent the insurance company and are not neutral.

In storms like this, large numbers of these freelance claims adjusters parachute in from out of town. In the industry, they are known as storm troopers.

"These guys have a lot of work to do, and it's a thankless job," said Matthew Tennenbaum, who used to be an independent adjuster but switched sides and now works for policyholders as a "public" adjuster in Cherry Hill, N.J.

Tennenbaum worries about the storm troopers' thoroughness.

"They're going to see 10 properties a day and they're quickly writing estimates," he said. "If they spend an extra three or four hours properly writing one estimate, they could have written three more and made more money."

The good news here is that these are not the people who make the final call on your claim. But many policyholders assume that their word is the final word.

Wind versus flood

Back at headquarters, other adjusters have their eye on an exclusion that will be crucial for this storm, with its horrific storm surges but relatively mild winds: Homeowner's insurance generally does not cover floods.

Unfortunately, many people do not know this and many more have not purchased or renewed policies with the federal flood insurance program that covers up to $250,000 of flood damage.

People without coverage but lots of damage from the storm surge might do one of a couple of things.

A few stubborn ones will sue, arguing that if the wind drove the surge then it's not really a flood. Judges haven't taken kindly to this line of reasoning over the years, but that probably won't keep people from trying again. The Federal Emergency Management Agency may also offer some assistance.

Others may try to prove that wind damage, which is generally covered, was responsible for the loss.

Then there's the concurrent causation clause that has crept into policies in recent years. Here, insurance companies refuse to cover anything if one thing that causes damage (like wind) is insured but another (like a flood) is not and both seem to have happened at the same time.

Replace and repair

After most storms of this size, prices rise. There may be a shortage of building materials, for instance, or the higher-quality materials may get more expensive. In the wake of two hurricanes in Florida, contractors turned to Chinese drywall several years ago, which ended up making people sick.

Your policy may call on your insurance company to pay for materials equivalent to what you need to replace, or it may merely require similar ones. But make sure its estimates reflect the new market price, lest you end up settling for what turns out to be this storm's Chinese drywall, whether it's bad lumber, paint, cement or something else.

Building codes

If you live in an old house, any major repairs will have to comply with newer local building codes. Homeowner's insurance policies may include riders known as "law and ordinance" coverage that will cover the extra cost of doing so.

But recovering the money may not always be easy. Some insurance companies make you wait to collect until you've already spent the money, then demand proof that the local code enforcement office insisted on every course of action.



Ron Lieber is the “Your Money” columnist for the New York Times. Reach him on Twitter @ronlieber.

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