Bait and Switch?

[rafiki]

Hi,

I recently, about 6 months ago, changed my homeowners insurance. We moved into our current home, which is our first, about 7 years ago. We have been with the same company up until our switch 6 months ago, due to the savings of combining our homeowners and auto under the same policy.

There was an initial inspection done of our home by the insurance agent, before we signed papers. After the inspection, the agent worked out with us our policy coverage and cost. However, after six months of coverage, for some reason there was another inspection done and now we are being told that WE, as a result of their inspection, have to pay to have our roof repaired, as well as, having trees with overhanging branches trimmed…..and some other things.

I am furious because had we known that we would have to incur these costs, which we don't have the money for now, we would have never switched to the new company. Furthermore, our previous insurer, one of the majors, did not have a problem with these things as they existed. It appears that the new company is attempting to be pro active in getting us to pay for things before they have to. I can understand that….but they should have done that PRIOR to agreeing to cover me. It seems unfair to get me to switch, then wait half a year and then tell me I have to have certain repairs done.

What are my rights in this regard? Please help.

 

[Mark]

I would call your state's ins dept and speak with them about this.

 

[xrac]

Switch companies again.

 

[Norwayguy]

I am furious because had we known that we would have to incur these costs, which we don't have the money for now, we would have never switched to the new company. Furthermore, our previous insurer, one of the majors, did not have a problem with these things as they existed. It appears that the new company is attempting to be pro active in getting us to pay for things before they have to. I can understand that….but they should have done that PRIOR to agreeing to cover me. It seems unfair to get me to switch, then wait half a year and then tell me I have to have certain repairs done.

First I am not a P&C insurance agent, but the reason your prior company had no problems with these issues is the policy would have excluded coverage...If you need to repair your roof because things are wearing out is not your insurance companies problem normal maintence is not covered under your policy. You can definatly switch back to your prior carrier but you should sit down and actually read your policy.

 

[Josh]

Odds are your original carrier was going to notice your house needed the work done at some point too. If you're roof is in rough enough shape that the insurance company is saying that you need it replaced, then you probably do. That being said, you can always change companies again. If you talk to an indy agent first and explain the situation then they might now which companies are sticklers and which are not.

 

[rafiki]

Thanks for all the input.


I totally understand and accept my personal responsibility and complicity. It always takes two to be suckered. My beef, notwithstanding, is born from the fact that my previous insurance company, two years ago, had sent out an adjuster, after a big storm, and told me that my roof was fine. They denied the claim, saying my roof was not in bad shape. It was a really fierce storm with hail and high winds. The normal storm chasers came into our community, after the storm, and were looking for damage roofs for businesses. They told me I had roof damage (lifted shingles). I say roughly half the homes in my community filed claims and had their roof repaired….but our claim was denied on the grounds that our tree coverage protected our roof.


Even though our claim was denied, our premium went up significantly about a year later, likely the consequence of everyone else getting their roof fixed through claims (speculation). My auto insurance company and agent, which is my new home insurance company, had been trying to get me to switch my homeowners over from the other company. He calculated the potential savings and I decided to make the switch for the savings, as well. I could have switched to the company that my homeowner's insurance origination, but the denied claim and rate increase led me to switch to my auto insurance company.


An initial inspection was done by my auto agent and then we worked out the details of coverage. No problem. Then, 6 months later, for some reason another inspection is done in which they bring up not only the roof, but 2 other items that have existed in the same degree since we moved in 7 years ago. I doubt very seriously that my old home insurer was going to come to my home anytime soon and say that my roof was in need of repair when just two years ago they denied a claim saying my roof looked fine. I personally believe that having filed a claim flagged me to my new company to go out and take a closer look at the roof before the next storm comes along and they have to pay out a claim.


If I have to spend several thousand dollars to get my roof repaired, you can best believe that neither my previous nor current insurer will be getting my business in the future and I have told my agent this. We spend nearly 3,000 dollars a year between home and vehicles. I am sure another company will be glad to have the business. I have only filed one claim in my life....and I am 48 years old...and that claim was denied. Again, it seems to me the due dilligence should have been done on the initial inspection. That is when I should have been told that I needed to have repairs done and not AFTER I switch everything over. As soon as the economy stabalized......I was going to have a lot of work done on the property, including getting a new roof (for esthetics). Now I cannot afford the debt that it would incur.

 

[VolAgent]

I wouldn't forget the agent's role in all of this. If you really felt you had a claim in the storm two years ago, he should have fought harder for you to get it paid. Also, I would be asking the agent why the roof passed inspection 6 months ago, but now it doesn't.

 

[markschneider86]

I have never heard of a company before doing 2 inspections on a home. I am interested in why they would do this. From the sounds of it, your house needs a new roof. I don't think the agent was intending this to happen.

As far as the wind and hail storm, you should have fought the insurance company. My advice would be to file a complaint with the insurance commissioner. You might still be able to get your claim paid. You have a lot of evidence that there was roof damage done. Hopefully you saved the estimate for a new roof, and where the roofing company found damage. Also in the fact of the latest inspection form your current insurance company saying you have roof damage. Google the Department of Insurance in your state. I think you have a good case. Especially how everyone else got a new roof.

Good Luck-

 

[WellAdjusted]

You have to remember there is a difference between a roof that is worn and needs to be replaced, and a roof that is storm damaged and needs to be replaced. If you have a 20 year roof that is 15 years old or more, or was improperly ventilated when installed, or possibly has a manufacturers defect, it may need to be replaced even if it's not damaged by a covered peril. This however would fall under homeowners maintenance.

The adjuster who came out 2 years ago may have missed the damage, or he may have made a proper assessment and denied the claim due to lack of damage created by a covered peril. If the roof was worn when he looked at it, it would have been nice for him (or her) to let you know.

Also, roofers will tell you just about anything to get a job. After all, no sell no money. Lifted shingles are typically not covered by insurance, as the shingles may not have sealed down after installation. If the shingles are lifted and have a crease in them due to wind folding them backwards, then that is damaged and the slope or roof will need to be repaired or replaced.

Lastly, rather than running straight to your DOI, find out from the new insurer if the roof needs to be replaced due to age and condition, or if there is substantial storm damage to the roof. If there is storm damage, call your previuos carrier and tell them you need a reinspection. They are still on the hook for any damage caused by a covered peril within their policy term.
- - - - - - - - - - - - - - - - - -

I wouldn't forget the agent's role in all of this. If you really felt you had a claim in the storm two years ago, he should have fought harder for you to get it paid. Also, I would be asking the agent why the roof passed inspection 6 months ago, but now it doesn't.

If the insured never got back with the agent to say they still think they have a claim, do you still believe the agent is at fault? Does an agent need to second guess and re-open every denial on his or her own? I think the agent did their part unless they were told after the denial that the homeowner was still unhappy with the results of the inspection.

 

[VolAgent]

If the insured never got back with the agent to say they still think they have a claim, do you still believe the agent is at fault? Does an agent need to second guess and re-open every denial on his or her own? I think the agent did their part unless they were told after the denial that the homeowner was still unhappy with the results of the inspection.

Yes, I still believe the agent played a role. If you just told someone their claim was denied, you can expect to get an upset reaction or a, "So, what do we do now?" At that point, the agent should have explained the options, or what he was going to do for the insured.