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How to Boost Your Odds of Getting Paid on your fire damage insurance claim if you go it alone.

September 8, 2011 | Articles, Sean Breen

Some people decide to go it on their own with handling fire damage claims with the insurance companies instead of getting help and legal protection. If you choose to do it on your own and if you want to increase the likelihood that your insurer writes that check that you paid your premiums for, there is much to do.

Don’t dillydally when it comes to reporting your claim: Insurance companies generally handle them first come, first serve.

Once your claim is reported, get your claim number and write it down. Having that number will make your life — and the insurance company’s — easier.

Find out a little about the adjuster who will come to your house to assess the damage. You want to know if he is an employee of the insurance company or an independent adjuster hired by your insurer. The answer matters: If the person is independent, get the name of the actual insurance company adjuster whom the independent adjuster is sending your information to, and find out whether they are authorized to make claim decisions and payments on behalf of your insurance company.

Beware of firms that demand up-front fees for services, regardless of the outcome they negotiate on your behalf with the insurance company. Public adjusters work purely on a contingency basis, ensuring that a homeowner does not pay anything unless he or she receives some form of settlement, says David Charles, president of Catastrophic Claims Consultants.

Build Your Evidence

Anticipate the possibility of push-back from the insurance company, and be ready to hit them with documentation. When you file a claim, HBH advises immediately starting a notebook detailing all your contacts with the insurance company. List the date, time and a brief description of what went down. If you need to amplify later, this will give you a leg to stand on. If an adjuster says he or she will not come out, for example, write it down. If an adjuster is a jerk, note that too.

You own a ton of stuff. Make a list of it all. Better still if you took photos of your possessions before the fire, but If you didn’t, don’t sweat it. Those snapshots from a party may offer proof of your TV that was destroyed, or the rug that was ruined.

Do, however, take photographs of the damage before doing any repair work to your home. Also, make an itemized list of all damage sustained during the fire and aftermath.  Do all you can to minimize secondary damage: Your homeowner’s policy requires that you “mitigate damage, ” which means try to make it less.

You’ll want to do some homework by getting a repair estimate from a contractor to help you in talking with the adjuster. Hang on to receipts for any emergency repairs, and costs such as if you have to stay in a hotel. This may be reimbursable under the “additional living expense” portion of your homeowners’ policy. Save receipts from temporary repairs and cleanup efforts.

If you need to leave your home, make sure your insurer knows how to reach you.

Require repair contractors to provide proof that they’re licensed and insured. Check them out with the Better Business Bureau (http://austin.bbb.org).

Get descriptions of repair work and cost estimates in writing. Never pay for repairs in advance.

Get your insurance company’s approval before major repairs.

Once an insurance company has received your claim, the company has 15 days to notify you that they have either accepted or rejected your claim.

Most homeowner’s insurance policies allow for an appraisal process to settle claim disputes.

Fight Back

Make sure you follow up on your case: Don’t just file the claim, sit back and wait for your payment. Check in regularly with your insurance agent or company on the progress of your claim. If your insurer denies your claim or offers a piddly amount, don’t just accept it. HBH advises demanding that the company identify the language in your homeowners’ policy that served as the basis for denying your claim or offering so little. The company may be right and you may not know it. Once the company pinpoints the key language in the policy, you should be able to make this determination. Then too, it could be that the company has craftily put new limitations into the policy and didn’t make them clear to you. If you feel misled, weigh whether you want to contact an attorney.

For example,  the introduction of percentage deductibles (up to 10% of the value of a home), could greatly shift the cost of the fire from insurance companies to consumers. The practice of shifting the cost of previously insured events back to consumers is acceptable, as long as consumers are clearly given the option to select the level of coverage they want with fully informed consent.

Another new way insurers can pull a “gotcha” is by putting a limit on replacement cost payments, which might come into play in the event that a home is totally destroyed. A typical cap is 20% above the face value of the policy.  If costs surge because of the spike in demand for materials or labor following a major event like this fire (or if the state does not monitor price gouging sufficiently) this limit might apply. For example, if a home was expected to cost $200,000 to replace and that amount was the limit on the policy, the insurance company would pay no more than 20% more, or $240,000. If the surge in construction costs due to extreme demand caused the price of replacing the home to jump to $300,000, the homeowner would be short $60,000.

Know Your Rights

The squeaky wheel gets the grease. Do complain to the powers that be in the insurance company if you feel like a denial was unwarranted or the reimbursement too little. Don’t stop there. Complain to your state insurance department: It will make an inquiry with your insurer.  See a lawyer if you want to take it a step further.

Once the insurance company tells you the reasons for its action, it legally can’t produce new reasons for denying payment or making a low offer at a later time. You have locked them in — a major advantage for you.

If you review the policy and find that, without stretching your imagination, it seems plausible that you should get the full amount of your claim, you will likely win if you go to court.  Courts consistently rule that if an insurance policy is ambiguous, the reasonable expectation of the insured party will prevail since the consumer played no part in writing the language of the insurance policy.

Contact the experienced attorneys at Howry, Breen & Herman, LLP if you need help.

The Austin based attorneys at Howry, Breen & Herman, LLP are experienced in representing homeowners, farmers, ranchers, businesses and churches in dealing with insurance companies on fire damage claims and available to assist you to see that you are paid the maximum of what you are owed on your claim. We can help ensure you get the maximum amount to which you are entitled. Call us at 1.800.404.9441.

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