San Diego Home Inspections — Claimed denied by your insurance company? Try this!

By
Real Estate Agent with RI Real Estate Services ~ 401-529-7849~ RI Waterfront Real Estate

 

Denial of a Homeowners Insurance claim by an insurance company is not that unusual and Russel Ray, who has helped clients before with these issues, gives instructive and must 'keep' advice for addressing this issue in this post.  Please take the time to read it, share it with others and print it out to put with your Homeowners Insurance policy.  You never know when you may need to access this information for such occurrences like your home furnace stops working or a roof leak does major damage to your walls- understand the insurance company's use of 'pre-existing' conditions and do not be put off by it.  Pursue, pursue, pursue your claim being honored...

 

http://www.russel-ray.comCall Russel Ray for all your home inspection needs


Claimed denied by your insurance company?
Try this!

http://www.russel-ray.comA Client from March 2007 called me recently about his furnace not working. With the arrival of cold weather (of course, cold to us here in San Diego is anything less than 65°F), many people are using their furnaces for the first time this year.

I always love it when a Client from yesteryear calls me with an insurance-related problem because that tells me several things:

  1. They remember me.
  2. They trust me.
  3. They remember what I told them about insurance.

http://www.russel-ray.comInsurance companies don't make money by paying claims, so their first line of defense is quite often just to deny the claim outright. Sometimes they won't even give you a reason. Other times they'll say that the __________ is not covered, or has pre-existing conditions. Their thinking is that you'll accept their decision and go on your merry little way.

If they deny your claim for whatever reason, ask them to reconsider. The second time around your claim will actually get "processed," meaning that you'll probably get more action than just a computer-generated letter denying your claim.

If they send someone out to look at things and then deny your claim because of "pre-existing conditions," well, that phrase is standard denial language. Call them on it with this little tidbit that has worked for me and my Clients:

Dear Insurance Company:

You had the opportunity to inspect the __________ prior to issuing a policy and accepting my premium payments. Because you did not do that, the fact that you issued a policy and accepted my premium payments mean that you warranted that the __________ was in insurable condition. Please forward to me at [address] either a check for [repair/replacement] of the __________ or a refund of all my premium payments from [date of coverage commencement to current date]. Thank you.

Sincerely,

Modify as necessary.

http://www.russel-ray.comNow send it by overnight mail to the insurance company and a copy, also by overnight mail, to the insurance commissioner in your state. Make sure that the copy you send to the insurance company notes that a copy has been sent to the insurance commissioner.

Insurance is regulated in all 50 states, so while you might not have an "insurance commissioner," there is some Top Dog somewhere who is in charge of your state's insurance industry.

Even if your policy excludes pre-existing conditions, if the insurance company didn't send anyone out to look at everything prior to issuing you a policy, they can be held accountable. Once they understand that they have a serious and knowledgeable Client on their hands, it's far less expensive to just send you a check and be done with it.

http://www.russel-ray.comEvery time I do that for one of my Clients, the insurance company sings a new tune. In fact, sometimes, a check arrives in their mailboxes a couple of days later, also by overnight delivery.

Of course, all of this is predicated on you repairing any problems that were noted in your home inspection report, and that you actually read the fine print in your home insurance policy. Nonetheless, it doesn't hurt to try.

My greatest success so far was a check for $11,950 for plumbing problems. All she had to pay was her $50 deductible, which had been deducted from the $12,000 plumber's invoice.

In this most recent episode, the insurance company agreed that the furnace was covered under their policy and that it would be repaired if possible, or replaced if repair was not possible. My Client's deductible is $100.


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This blog © and its contents is original to Ginny Lacey Gorman

the RI waterfront Realtor of Choice

 

Ginny L. Gorman, a purveyor of Fine RI Waterfront Real Estate   

Specializing in waterfront, ocean front, vacation, coastal and luxury homes for sale in North Kingstown, South Kingstown, Narragansett, Jamestown, Charlestown, East Greenwich, Exeter, West Greenwich RI and beyond ...  I sell dreams!  Because there is no place like home...the RI Real Estate Agent in the Sparkly Red Shoes.

 

Looking for a knowledgeable Rhode Island Real Estate Agent?  Let me GOOGLE one for you!

            

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Rainmaker
2,941,347
James Dray
Fathom Realty - Bentonville, AR
Exceptional Agents, Outstanding Results

Nice Ms. Ginny good information

Nov 25, 2010 11:02 PM #1
Ambassador
2,758,551
TeamCHI - Complete Home Inspections, Inc.
Complete Home Inspections, Inc. - Brentwood, TN
Home Inspectons - Nashville, TN area - 615.661.029

 

Good Morning Ginny. So goes the problem with most insurance companies. They ALWAYS find an out and the "preexisting condition" caveat is the most widely used...

 

Nov 25, 2010 11:15 PM #2
Rainmaker
1,793,777
Ginny Gorman
RI Real Estate Services ~ 401-529-7849~ RI Waterfront Real Estate - North Kingstown, RI
Homes for Sale in North Kingstown RI and beyond

James...need to check your dreidling today on words...thanks

Michael...you would know too best...i've always pursued things vigorously with insurance companies but many homeowners do not...best

Nov 25, 2010 11:21 PM #3
Rainmaker
2,309,508
Anita Clark
ColdwellBanker SSK Realtors ~ 478.960.8055 - Warner Robins, GA
Realtor - Homes for Sale in Warner Robins GA

This is one I thought about re-posting myself.  Excellent information to have in-case it's ever needed.  Thanks for re-sharing it Ginny.

Nov 25, 2010 11:40 PM #4
Ambassador
2,299,411
1~Judi Barrett
Integrity Real Estate Services 118 SE AVE N, Idabel, OK 74745 - Idabel, OK
BS Ed, Integrity Real Estate Services -IDABEL OK

Pre-existing will bite people on just about every kind of insurance.. Our son had a burned hand when he was small..  because the insurance paid for the treatment, they excluded anything that might happen to his hand from that time forth...  we changed insurance in short order and there was not a problem.

Nov 26, 2010 02:43 AM #5
Rainmaker
1,793,777
Ginny Gorman
RI Real Estate Services ~ 401-529-7849~ RI Waterfront Real Estate - North Kingstown, RI
Homes for Sale in North Kingstown RI and beyond

Anita, i printed a couple copies of the article to keep in my homeowners file so I don't misplace it...it is excellent and Russel knows his stuff.

 

Judi...it is amazing what insurance will not and will do...i've gone through huge business disasters with fire and they will do everything to not pay...teams are lawyers at great expense was what made the difference...thanks

Nov 26, 2010 03:41 AM #6
Rainmaker
1,009,426
Kevin J. May
Florida Supreme Realty - Hobe Sound, FL
Serving the Treasure & Paradise Coasts of Florida

Ginny, I usually read Russel's posts and don't know how this one got past me.  Thanks for the tip and I'll head over his way.

Nov 26, 2010 02:48 PM #7
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Ginny Gorman

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