Master Insurance Claim- Big Frustration!

[snoodle77]

I have a condo that's under 1 year old. More than 2 months ago the sprinkler pipe broke because the heater in the room where the pipe is was not on (only the developer had a key to that room). Unfortunately, my unit is right next to the room so my place was 'flooded.'

Things got complicated. The property management, developer, and the condo board wanted to avoid filing a claim with the master insurance (Travelers), so they asked me (on separate occasions) to handle this on our own. The developer knew it's at fault but refused to address moisture issue under the wood floor (they just want to resurface the floor but not doing any testing to ensure the floor was dry or any potential mold issue in the future). I got two inspection reports stating the floor was still wet (even after professional drying) after 4 weeks, and both recommended replacing the floor. The developer refused and said resurfacing would take care of the issue. After I threaten to sue all parties, the condo board finally filed a claim with the master insurance 7 weeks after the event. Note: my insurance denied coverage because it's covered under the master insurance.

I thought since there is a at fault party, the process should be easy. For some reason, after the adjuster and a technician came out, they sent an engineer out. The technician took moisture reading and (not surprising) the reading was high. The engineer came out 3 days later and didn't want to take any readings (he acknowledged the he knew the reading was high).

That was 2 weeks ago. Now he wants to come back to take moisture readings.

What could be the reason for this? If I have reports saying the floor is beyond repair 2-3 weeks ago, would it make a difference if the floor is dry now? I want to refuse the request but I don't want to not get the money. I don't want to have this drag on forever but not sure what I can do at this point.

Your comments are appreciated.

 

[b61mack]

Google the man with no face! Send a copy to the the board! and your insurance co. With a letter from a lawyer! Mold can be a killer! Put on fans to draw the mositure outside.

 

[VolAgent]

The floor was still wet over 7 weeks after the flood, you have mold. What happens at this point really doesn't matter, the mold is there. Has anyone even lifted up the flooring to check underneath?

You need to cooperate with the insurance company and its contractors as best you can, but don't allow them to become unreasonable. I would ask the engineer the purpose of his return visit. Not just what he wants to do, but why he wants to do it.

 

[jhuang]

If you don't have representation, get one fast. Developers are only looking to cut any expenses they can (including their own liability when building new homes). HOA's are governed by rules as well, therefore you need legal representation.

 

[b61mack]

Make that Mark Tatum, the man with no face. A toxic mold strain, ate off most of his face! It is the extreme, but that is what insurance is for! Knock on the neighbors doors, MOLD SPREADS, the whole building is in danger! Make some noise!

 

[djs]

Why did your insurance deny the claim? The fact the master policy is there shouldn't have mattered.

Or did you not have building property coverage?

I agree that you need to cooperate with the insurance company, but they need to cooperate with you as well. Ask them if a contractor to do the repairs is coming along when they take the moisture readings.

Contrary to popular belief, the amount of the claim isn't an issue. To the HOA / developer, a claim is a claim. Period, then end. The insurance company won't pay more than they have to, but letting it sit isn't helping anyone.

The engineer is probably just wondering why the floor didn't dry. He may be looking for an unrelated problem.

Are you on the bottom floor? Is the floor on concrete?

Dan

 

[Accelerated]

Why did your insurance deny the claim? The fact the master policy is there shouldn't have mattered.

Condominium bylaws are tricky things, and they vary by state and by owner. I have encountered several condos that had bylaws that clearly stated that the floors and floor coverings belong to the condominiums. That would likely be why the claim was denied to the insured.

 

[b61mack]

This is a time, when you need a lawyer, to send a letter, putting them on notice of a possible 10,000,000+ lawsuit, including all the board members personally! This is not a triffle matter.

 

[BIG RED IS BACK]

file a claim on your policy and the master policy and let them battle it out,

usually, your policy will pay the larger master policy deductible and then the master policy takes over.

 

[Accelerated]

file a claim on your policy and the master policy and let them battle it out,

usually, your policy will pay the larger master policy deductible and then the master policy takes over.

The insured's policy will not pay anything at all if they have a copy of the bylaws/articles of incorporation that indicate that the floor and floor coverings are "common elements" within the unit boundaries.

For example, a recent claim occurred, in which are Articles of Incorporation and the condominium Bylaws said:

Unit Boundaries means the vertical and horizontal planes which define the outer limits of a Unit, as shown on the Plans, as said planes coincide with: the undecorated interior surfaces of the perimeter walls, the exterior doors and the exterior windows; the undecorated lower surfaces of the ceiling and the upper surfaces of the sub-flooring

In layman's terms, and in this specific case (the OP's bylaws were likely different, as everyone has their own version), this means that the adjuster takes those bylaws into consideration and determines that the insured does not own the walls or ceiling in the condo, only the finish on whatever the material may be (paint or stain, fixtures, that kind of thing). Inasmuch as the section regarding flooring is questionable, it would be arguable either way. Most bylaws are more specific, this one was not.

The best thing I can recommend to the thread starter is to read the bylaws and articles of incorporation for your condominium. See if you actually own the floors or the floor coverings. If you do, pursue it with your insurance company. If the condo owns them, you have a range of options available to you to pursue the costs of damages sustained from the loss.


In the case I described, the insured lucked out and did not have to get into a battle regarding the floors, which sustained heavy damage, since the carrier had both the homeowners policy and the condominium policy, and it was just a matter of deciding whose policy they wished to include the damages on, since they were paying for them one way or the other.