Water damage job/ adjuster question

[1st choice restoration]

Went to a commercial loss that roof got affected by storm... Insurance adjuster depreciated out roof and only paid 25k which won't pay for entire roof which I understand. They discovered water damage after all of this. Will and should adjuster pay my bill??

 

[1st choice restoration]

I meant will adjuster pay for my bill for the water cleanup and drying or is that supposed to be part of the 25k?

 

[Big Jim]

I meant will adjuster pay for my bill for the water cleanup and drying or is that supposed to be part of the 25k?

John, The mitigation service(s) you provided are considered separate from reconstruction and those associated costs. We often tell our customers to think of it like a double header baseball game. Same teams, same place, same day (almost) but totally separate results. No one here can tell you what your customer's policy will or won't cover. There may be separate limits for mitigation and reconstruction or a combined coverage limit. That is something dictated by the policy. If you were hired by the property owner payment is ultimately their responsibility regardless of what the policy covers. Much more depends on your agreement/contract, what it states, and who signed it.

 

[Desk Jockey]

Don't take any chances, write up a ball park estimate and collect the deductible prior to begining work. If they balk at the price or payment, might as well get it out in the open before you're deep in it.

 

[1st choice restoration]

I'm just trying to help my customer with adjuster... Is water damage bills normally paid for along with the roof with insurance?

 

[Desk Jockey]

Yes it could be, its all a part of "Structure".

The definitive answer is to call the adjuster, just to be sure. My guess is yes, he cut one inclusive check.

 

[Big Jim]

It's nice of you to try and help your customer with their claim. It helps to know what is considered to be "customary and traditional" with regard to most claims, and that varies a great deal between commercial and residential. If you have a good deal of experience you may offer to provide that information. Here's the problem. ... Once you go there customers will sometimes say " you said my insurance would do/ccover this". It is the insured' s responsibility to know what their policy does an dose not cover; not yours to speculate. As I have often been told when asking questions about some piece of equipment; RTFM. It means Read The F........ Manual. In this case politely tell your customer to RTFP (POLICY)

 

[Desk Jockey]

I agree with Jim, we are not agents or adjusters, don't try to interpret policy. Most agents won't even do that, they push to the adjuster to do.

All you're asking for is a scolding when Mrs Homeowner tells the adjuster "but my carpet cleaners said..."

The best help you can be for the homeowner is steering her back to the adjuster for an answer.

 

[1st choice restoration]

No no. I'm simply trying to encourage customer to explore that option and see what they will cover... I'm thinking adjuster in unaware of the water damage inside.

 

[Big Jim]

No no. I'm simply trying to encourage customer to explore that option and see what they will cover... I'm thinking adjuster in unaware of the water damage inside.

The question would be; why would the adjuster be unaware of the mitigation service performed? As a courtesy to our customers we always provide their insurance carrier with a copy of the mitigation service invoice as soon as it is completed, and provide a follow up call (voice mail) to confirm all documentation forwarded was received. Even if the carrier denies the claim you have completed your due diligence and have expedited the payment process. You should assist your customer in every way possible including emphasizing their (the customer's) rights and responsibilities. We also provide the customer with a full page of information on that very subject. Hope this helps.

 

[1st choice restoration]

The adjuster is unaware because the customer just discovered it

 

[Big Jim]

The adjuster is unaware because the customer just discovered it

It appeared or "I assumed" by what was stated that the mitigation services had already been completed. Either way the mitigation would need to be/have been completed to protect the structure, and everything stated previously still applies.

 

[Desk Jockey]

My concern would be if this were "hidden moisture" just found, can it be dried at all. How long has it been sitting? It maybe that because its been sitting so long you now have a microbial concern. I'd be very cautious about drying these area, you could cross contaminate unaffected areas. If the decision is made to dry the structure I'd want to contain the area and remove under neg air just to be safe.

Personally if its more than a couple of days, I'd lean towards removal.

 

[Big Jim]

My concern would be if this were "hidden moisture" just found, can it be dried at all. How long has it been sitting? It maybe that because its been sitting so long you now have a microbial concern. I'd be very cautious about drying these area, you could cross contaminate unaffected areas. If the decision is made to dry the structure I'd want to contain the area and remove under neg air just to be safe.

Personally if its more than a couple of days, I'd lean towards removal.

Good Point. If the mitigation/remediation has not begun, the first things to consider are the category of water loss (1,2,or,3). Then what materials have been affected, and how long has the moisture intrusion been present. All of these factors dictate what happens in what order. The inspection allows you to create the scope and estimate. At that point it's not a matter of whether the work needs to be done, just more who's going to pay for it.

 

[Hoody]

My concern would be if this were "hidden moisture" just found, can it be dried at all. How long has it been sitting? It maybe that because its been sitting so long you now have a microbial concern. I'd be very cautious about drying these area, you could cross contaminate unaffected areas. If the decision is made to dry the structure I'd want to contain the area and remove under neg air just to be safe.

Personally if its more than a couple of days, I'd lean towards removal.

The crazy Kansas guy is dead on - as usual. If you disrupt any microbial activity with air movement or any energy what so ever and it cross contaminates another area, it's your butt on the line for it. Think of it as the last contractor to touch it is liable. Most adjusters do not want to pay for anything mold related unless there is an extension of the policy. However here is the thing, if the water came from the roof it is considered rain water and can easily be classified as CAT 2 or 3. I would look to contain the area(s), remove affected materials, clean, and dry. If not only for a liability stand point, I think it would be a disservice to your client, and the possible health concerns for the people who are regularly in the building.

 

[Greg Cole]

I'm just trying to help my customer with adjuster... Is water damage bills normally paid for along with the roof with insurance?

It's NORMALLY two separate bills

 

[Floodguy]

You may run the risk of a denial if you choose to tear out insured items of property before the adjuster inspects the loss. When this is done, the insurer's rights to properly investigate the loss is prejudiced which can lead to a denial per the insuring agreement. If the water category is not poor and dry out is possible, document the loss with photos, a properly completed drying log and a moisture map. Such effort to prove the loss, the scope of damage, and method of repair, helps the adjuster to agree with your estimated cost to repair.

 

[PrimaDonna]

I know they sometimes get a bad wrap....but maybe you could suggest a very reputable insurance adjuster (there are some out there) that could work on the customer's behalf to get more money from the insurance company. Sure they will take a percentage, but they often get much more than the homeowner would. We have one that we work with and his company has always done right by the referrals we've given. They know the industry and the game. They take over all communication and negotiations between homeowner and insurance company. It's not too late to get them involved. We've seen our guy get additional money for the insured long after it was supposedly settled.

 

[Floodguy]

So long as the water loss mitigation work is properly documented, from my perspective the effort alway is to pay the loss. Lots of restorers and adjusters out there do not fully understand the S500 or were certified under a previous edition prior to 2006 or need recertification.

 

[Desk Jockey]

The issue we see is Third Party Evaluators trying to earn their keep by cutting invoices across the board.

There is a lot of "We don't pay that" with no justification. No regard for the standards and inconsistency among carriers.

Its the Wild Wild West out there.