Homeowners' Insurance problems

[phoenix1979]

What is the name of your state? KY
A couple of years ago, a storm came through my area and heavy rain, ice and wind damaged the gutter on the back side of the house along with a few shingles on the roof.
An estimate was submitted for new gutters, but the insurance company decided it was too expensive, which I believe is within their rights..
Unfortunately, they had a part-time "handyman" come do the repairs. The damage was done in late 2001, and the repairs were not made until early 2002. By this time, there was more water damage to the soffit area where there was no gutter. The people came and patched the area with new parts, but water continued to seep between the mounting surface and the gutter, possibly indicating improper installation. The roof itself (a couple of missing shingles..) wasn't a major concern at the time.
Now, the insurance company has decided that they will refuse to cover any future damage to the gutter or roof because of the current state of the gutter itself and a couple of missing shingles along the edge.

Since it was their lack of a timely and effective repair that caused most of the damage, can they do this?
Can I take any action against the insurance company over this, or is it too late?

Thanks in advance for any information.

 

[WHATCO]

Live in TX.

Apparently they can. I had a $13,000 covered water damage loss to my home. My insurance company sent THEIRr Preferred Contractor to begin repairs as they (collectively) arrived at a damage assessment. One week after THEIR contractor came out and only PARTIALLY removed some of the water damaged items, they (their contractor) showed up to collect their drying equipment stating they quit. Reason given was they did not have enough manpower to finish my job. The wet materials left unremoved and untreated by their contractor developed mold and spread throughout my home rendering it uninhabitable. I became very ill. I complained and my insurance company had a meeting where they decided it was my fault that the repairs were not mitigated. Therefore, based upon policy language, a large portion of my "continuing damage" claim was denied. This left me without enough funds to safely and properly repair my home. Almost 2 years later I still live in a trailer in my driveway unable to enjoy my home. Seems lawyers can't figure out the insurance company did anything wrong and/or afraid of them.

 

[tammy8]

You as the insured has a duty to protect your property from further damage. Sounds like you didn't. Why didn't you just pay to repair the damage and turn that into the insurance company?? It would have caused you to not have further damage.

Read your policy. I almost bet my last dollar that your policy reads something along the same lines I stated above.

 

[WHATCO]

So are you saying that if a person has a $40,000 house fire, that person should make repairs then turn their claim in? I suppose if a person did so, then they would have mitigated their damages (motel living expenses, etc. Right?) Would the insurance company, while doing its investigation, then say the insured did the right thing by making their repairs before the complete scope of damages was concluded? How is a company to arrive at a dollar amount if the repairs are completed before any damage assessment can be made? Are you saying a company does not mind it the insured "destroys the evidence".

I fully understand if an opening is made in your roof, yes, you cover it. If you have a large water damage, you stop the leak then do your best to dry it out (mop it up, rent dehumidifiers, etc.). That is mitigating one's damage. But when a company knows they owe $13,000 on a large water loss, (read your policy) they have a required obligation to pay what amount they know they owe within 5 business days from the date the liabilility becomes reasonably clear. NOT merely hold the insured's money for a month thus preventing their insured from mitigating their damages.

In my case, I immediately stopped the leak. I promptly called my agent and reported my claim. I cleaned up the water. I hired a company to bring out dehumidifiers. I left the damage, per the company's instructions, for the adjuster to see and scope. My company even asked if I noticed anything about my water damage that I had not discussed with them. I told them about a musty smell and they replied, "that is what we needed to hear". I found out later they were then well aware that mold was likely present. Despite this knowledge and that I had been getting progessively sicker, sent out an adjuster with little to no water damage experience. Since they were put on notice, why did they not send out a mold adjuster and nip it in the bud? Interestingly, my insurance company, however, decided to have their adjuster keep looking at roofs with "possible" hail damage for a week before he would come out. That is not my fault. That is NOT what I call a prompt investigation under these circumstances.

I agreed to use the company's contractor, which they called and dispatched to my home, in another attempt to keep trying to mitigate my damage. It is not my fault that the company's contractor did NOT act responsibly and tear out ALL water damaged materials as they should have (not to tear out all the water damaged materials was a decision made by both the contractor and the company adjuster standing there with them, despite my concerns). It is not my fault that my company's contractor rushed to secure workmanship on my job all the time knowing they did not have the manpower to complete the job and refusing to inform me of this (misrepresentation; by both the contactor and company?) My company kept selling me on how their contractors are thoroughly screened and dependable. Otherwise, they would not recommend them (and I would never have agreed to use them). It is not my fault, again, that despite repeated requests to send me some money, that my company refused to timely pay my loss so I could get my repairs made. (My company held my job hostage and caused me damages.)

It is not my fault that due to the misrepresentations by both my company and their contactor that mold developed in hidden places then grew and expanded. It is not my fault that once I had discovered hidden mold in the areas I told them needed to be torn out, that my company said I now have a mold claim and I must wait for them to do a mold investigation; that making any repairs now might spread the mold around the house thus making me partially responsible for additional contamination. It is not my fault that my company hired a environmentalist to intentionally ignore HIGHLY suspect areas where mold would likely be found from the water damage; and it was.

It is not my fault that once a prompt "true" environmentalist investigated and prepared a competent assessment report, (he also stated my company's man did not even follow NY standards), that my company would then deny damages they failed to timely pay for, instructed not to repair due to possible contamination spreading, and that they caused.

I stand to disagree with you that I failed to mitigate my damages. I did everything an insured was reasonably required to do. I would hope a jury would agree with me.

A company just does not make an insured rebuild their house with funds out of their pocket while the company keeps the insured's money to conduct their daily business. Are you saying this is proper conduct of an insurer?

 

[tammy8]

WHATEVER

I was replying to the OP. Mold is a totally other ballgame. Why do you think that Texas has such a hard time keeping homeowner companies writing business in TX.

Back again, the OP said that the damage happened in 2001 however was not repaired until 2002. A gutter is not as expensive to fix as a moldy home.

 

[WHATCO]

OPPS!

Sorry tammy8. Must be glitch in board. I received a notification in my e-mail that you had responded to my message. Again, I appologize for sounding upset. However, I am still not convinced about validity of the insurance situation in TX. Farmers was caught "red handed" cheating its homeowners policy holders in TX. They threatened to pull of to TX if they were to be punished for their crime. TX citizens went on the news and told them bye. Later, they were back writing H/O policies. If they were losing so much money, then why would they come back? Besides, why do we not hear about all the mold claims in CA, FL, and other states. Most believe that TX Ins Comm and Governor were for sale and sold us out to special interests. Other companies were also caught price gouging policy holders and were fined. Of course we will never see the money; just makes the politicians look good. You know, if the Ins Comm says the companies are justified in raising rates by 14%, but the companies raise them 200%, then the Ins Comm & Governor works a deal with the companies to roll back their rates by 28%, they boast to the public about what a wonderful job they did for the citizens. However, many people can't seem to understand that they are still paying a 178% increase! OR, maybe we will just remember on election day.