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Making Sure Your Insurance Is Working For You And Ten Signs It Might Not Be


Your home or business is hit by a disaster – hurricane; fire; flood – you name it.  Homeowners and businesses often have insurance to protect against disaster – and many times the dealings with the insurance company will go like butter. This is great news. However, there are other times when an insurance company gives their client the short end of the stick.

Most concerning, we’ve found in our work at ZMFF&J that too often a home or business owner – used to sharpening her pencil in other negotiations – will meekly accept whatever check comes down from on high by the insurance company. Home and business owners – especially small and medium business owners – need to understand and approach settlements with their insurance company as a negotiation and defend their corner.

My colleague Scott Hunziker has years in the saddle representing everyone from homeowners to the smallest of businesses on up in negotiations with their insurance companies in the aftermath of a disaster. As an expert in the field of insurance provider breach of contract and bad faith practices, Scott provided me with the top ten red flags that suggest a home or business owner may want to consider bringing on an attorney to help ensure all goes well (commonly these representations are contingency fee arrangements – you only pay the lawyer if things go your way):

The Red Flags:

1.      Insurance carrier refuses to respond to your claim, or to the evidence you provide in support thereof;

2.      Carrier continues to seek additional materials from you, even if they have no relation to what you’re claiming;

3.      Carrier delays and delays in sending adjuster to your home for property inspection;

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4.      Carrier’s designated field adjuster arrives at your property, and refuses to ascend roof or undertake thorough inspection because he/she “knows there aren’t damaged homes in this area of the town/neighborhood”;

5.      Carrier’s designated field adjuster arrives and either states or suggests that his/her assigning carrier “won’t allow him/her to pay for a specific element of damages claimed for that particular storm”;

6.      Carrier’s field adjuster admits to observing covered damage, but then a new adjuster is assigned with no reason given;

7.      Carrier begins by sending an engineer to property to fight causation, rather than merely sending a field adjuster to determine damage amounts;

8.      You face a continuing carousel of changing desk adjusters, who are always “getting familiar with your file”;

9.      You receive a small undisputed payment for damages, then a series of additional checks for “additional previously unnoticed damages” (each check acting as a concession that their previous payment was wrong); and

10.  You receive a series of letters from carrier that continue to add new excuses for denial or underpayment.

If you are seeing one or some of these flags, you may want to consider bringing someone to your corner. We’ve found that when the insurance company lawyers realize that they are dealing with a lawyer on the other side – it is not uncommon that sunlight and bluebirds are the result. The key is getting a fair result as quickly as possible so you can move on with your life.

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Here are just a few examples of homeowners and business owners obtaining good results after bringing an advocate to the table on their behalf:

When one family-owned restaurant lost its entire business to a fire, the tragedy was compounded when their carrier informed them that their coverage was deemed deficient and offered the family zero dollars. The family attempted to remedy the situation themselves with little success — and compared the legal hurdles to brick walls as opposed to speed bumps. However, when the family retained counsel, the issue was resolved in a matter of weeks. The end result? A $225,000 settlement. Happy day.

In another situation, a married couple had suffered storm-related losses when the tile roof on their family residence was severely damaged. The insurance provider again offered zero dollars to the homeowners. The couple had attempted to take on their insurance carrier for a year and a half before bringing on an attorney. It turned out to be the right choice, as the family wound up with a $160,000 offer from the provider in record time.

When disaster strikes, it’s always preferable when an insurance provider does what is expected of them. However, that isn’t always the case, and going toe-to-toe with an insurance company can be a daunting task. The key to sunlight and bluebirds? Ensuring that your interests are adequately represented.

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