Academy Journal

A Personal Claim Story – Part 2

By | April 12, 2022

In what feels like a Neverending Story (cue the music), we are still dealing with that open property claim that you might have read about in this classic, A Personal Claim Story – Part 1. You’ve probably already guessed it, but this is part 2.

I’ll be honest, it hasn’t been nearly as bad as you might think since we’ve been working on things since the end of February. It just feels like it is taking a long time. When last we reported in, we had contacted the two different insurance companies, getting claims reported, opened, and desk adjusters assigned. So far, our loss of use claim has been pretty bland so I’m not going to dive too deeply into that. It is enough to say that the additional living expenses so far are getting paid appropriately.

The other insurance company that is dealing with the damage to the house assigned a field adjuster, who came out, took pictures, asked some questions, took some measurements, and reported back to the home office. That’s where we were.

The building loss is being handled in three phases (because I don’t have a better way to think about it), the initial water remediation claim, the ensuing asbestos remediation claim, and then put everything back together claim. So, what’s happened so far?

If you don’t remember what happened, let me remind you (because I certainly remember). There was water in the bathtub, and someone let the water out and at the same time, flushed the toilet. All of that water did not go into the septic tank, as it’s supposed to do. It came up from under the toilet.

That amount of water needed somewhere to go, so it drifted under the tub and out of the bathroom, under the vinyl flooring in the hall. Then it migrated under the same floor into the living room. Now that you remember the problem, let me catch you up on the claims so far.

The first thing that had to happen was that someone needed to clean up the water. Now if it weren’t just so much water and it was going wherever it wanted to go (like under my practically new flooring), it wouldn’t have been an issue. We could have cleaned up if it were just some clean toilet water, but let’s face it, it wasn’t just clean water.

So, we called the water cleanup people. They came out and did what they do. They started to identify where the water was going. This was pretty cool because they had moisture detection devices that told them where they could find some water. That’s how they ended up not taking up the flooring in any of the bedrooms. They discovered that the water didn’t go there.

That’s when they started taking up flooring and with every vinyl plank that they took up, they found more water. That’s how the whole hall and living room ended up without any of the flooring. Then they noticed another layer of tile and started to scrape at that. That’s when we got a little more involved because we suspected that the underlying tiles were made with asbestos. No one knew for sure, so they stopped scraping those up and sent some samples to the lab.

More on that in another post.

The next thing that they did was to cut the drywall away up to a height of 24 inches. I know what you’re thinking, the water didn’t go that high. Yep. I thought that too. They told me that it’s their standard protocol to cut that high whenever there is an indoor flooding situation (their words, not mine. Remember that I’m happy calling it a non-weather water claim.). Add to that the sort of water that it was (the icky kind), and they just cut that high.

Once the flooring was up, the obvious water was taken care of, and the walls were cut open, they brought in the dehumidifiers and air scrubber. The dehumidifiers aren’t like the ones that you might have in your basement, or over at grandma’s basement. You know those big things that sit in the corner and every once in a while you have to empty them, and they have that funky dehumidifier smell. Not those. Think giant hot air machines blowing across the floor and making a proper racket.

That was the gist of the water remediation claim. There was some negotiating and conversation between the company and the insurance company, but that’s not important right now. Here’s what we should be focusing on, why didn’t we wait until the insurance company said it was ok and tell us who to call? Because I knew that we had a covered cause of loss and whether we did or not, someone needed to get that water up.

How did I know that we had a covered loss? Because I read this sentence.

We will pay for direct physical loss of or damage to Covered Property caused by or resulting from water that backs up or overflows from a sewer, drain or sump.

You already know that there’s more to it than that, but that’s the sentence that provided the coverage for direct physical loss of or damage to Covered Property. So that’s what authorizes us to get someone in to clean up that water and cut holes in walls and take up the flooring. All of that is covered property. Since it’s covered, these are going to be covered costs and all that’s left is figuring out what gets paid to the contractor who did the work.

Would the insurance company have liked to have an opportunity to discuss the clean-up costs first? Probably. Did it matter to the people who needed yucky water cleaned up and out of their house? No. What mattered most was getting the water cleaned up. Did the insurance company and the contractor have negotiations about what this should cost? Yes, they did, and I signed a piece of paper that allowed them to discuss it.

From an insured’s perspective, if there is a disagreement between the contractor and the insurance company about the cost, let them argue about it and stay out of the argument. There were a few times when I wanted to put my two cents in, but I realized that they didn’t need my input. They needed to work out these details.

The other side of this coin is that the insured should keep control of the money. I’m not a fan of assignments of benefits. That gives the contractor too much control. Let them talk to the insurance company. Don’t let them demand the money directly from them. Keep control of the money so that you can make sure that you don’t get blindsided by a contractor suing your insurance company on your behalf and then next year your insurance company nonrenewing for claims history.

What’s next? The asbestos problem, but that’s a problem for another post.

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