Need Advice on a Denied Roofing Storm Claim

[BubbaBanjo]

We recently had roof damage in FLA between the house and garage wall on our home in a tropical storm. Major amounts of rain fell with wind and several leaks opened up.

Good Hands.... our insurer, is denying the claim saying we neglected maintenance. I knew this was going to happen because of the demeanor of the adjuster at our home. Just got that bad feeling as he was there. He did all the talking and listened to nothing. You just know when you are talking to a scammer.

We had 2 areas where the boards in the attic looked water worn but we had no idea. A wall had water damage inside it after we opened it up. The wall sheeting was water damaged, but again we had no idea until now. Nothing was visible to us and we just passed Wind Mitigation inspection in January 9 months ago. We had a new fuse box put in that wall 2 years prior and there was no damaged wood then. It seems to have run down from a bad area in the roof.

The adjuster also started started spewing all kinds of other accusations about what he claimed Good Hands would never allow on the installation of our roof. We had it re-shingled after a Hurricane 8 years ago. It passed city inspections and Good Hands was never there in any capacity to advise us at that time. We have been paying them for 20+ years and they denied our claim. We were low balled on the previous claim also I think 8 years ago and have paid these guys a "lot" in FLA. Almost $18k since then.

Do we have any recourse and can you advise us on how to get even a partial settlement? We are at wits end. No idea how we can fix this on our own.

Please dont advise lawyers....I dont think we can win a lawyer battle with an insurer and our roof would cave in by the time we did even if we won. We are just trying to hang on to our home and have no idea what to do.

It looks to me as if we need 2 roof sheeting panels replaced and at least the front side of the roof re-shingled. I dont think doing only the attached garage is allowed by the city. The back is separated by a ridge vent and "maybe" just the front could be redone. God if they offered anything fair we could get it done but the whole cost will sink us. Its so hard to hold on to the home getting squeezed from all sides. Please help!

 

[TeePee]

Not truly understanding what you mean by water worn? Water worn means there might be long term damage (leaking over a period of time). Is this what the adjuster is saying?

 

[NCAgent]

Read your policy language or talk to your insurance agent. I'm not licensed in FL anymore but some states give you the right to have another adjuster look at the loss for a second opinion. If there is a disagreement then you get a third party to do it. Some companies allow arbitration settlement if it gets to that point and it could go either way, though I doubt it will get that far for you guys.

You can also have the state DOI investigate as well. Most states have a number to call if you believe a claim wasn't properly handled.

Try to have the adjuster look at it again or talk with their supervisor, see if they can have another adjuster look at it?

Also, not to sound rude or biased, but as a client you are not going to be able to explain the claim the way an insurance professional would. So there are probably a few details missing that make this sound less cut-and-dry. However, there is verbage in nearly every policy that uses "sudden and accidental" for losses meaning unintentional and not accumulating over time (such as wear-and-tear). If there was damage that had accumulated over time that contributed to the loss then it very well could be denied.

None of us will know, however. Hence talking to another third party.

 

[b61mack]

Talk to a public adjuster i think that is what they call them, They act in your behave against insurance company. Or sue them in small claims court.