Complaint Review: American Family Insurance - Columbus Nebraska

I am a 40 yr Executive Claim Adjuster now working as a claim advocate for policyholders being victimized by greedy insurers. You have not heard of the claim tactic being used nationwide now known as delay-deny-defend on claims. It serves to make you go away and feel helpless and it really works. Most denied claims are not pursued, however a State study shows 90% of the denied claims had some element of merit and should have been paid as they were in the prior generations, that goodwill is what built the insurers in the 70's. Another study shows of those who pursue their claims with a claim advocate are almost all paid.

Almost all the large carriers now practice this bad claim protocol by delaying the claim as long as possible until your angry then deny the claim without a proper investigation and cause you to defend yourself. Lest you forget, you need only file the claim, its up to the insurer to prove that the loss is not covered. Thats how its suppose to work.  Now they do use their own hired guns ie contractors, adjusters, and attorneys to tell a version of the truth to deny the claim. 

Hail claims are a big issue. Almost every one can be reversed if pursued. Nebraska and Indiana were two States who had over 55,000 hail claim complaints that were all denied and the State made the carriers reverse them all and pay the roofs. State Farm was the biggest offender followed by others. You should not take the adjuster report as fact. He probably took photos using the satelite pictures now being used without ever taking photos on top of the roof face to face.

 Technology is being used everywhere in place of human interaction today to determine your roof damage.  Most hail claims need to be looked at in the night or with water sprayed over it for lite damages. Other covered hail claims can be simply "bruised shingles". It is considered damage. The roof life has been shortened so its damaged. The carrier will claim the shingle integrity has not been hurt, but thats not true. A year later in the heat the shingles will curl or break/crack where the hail hit it.

Obviously you already went to the Dept of Ins who is bought off by the carrier. Yours may have no integrity unlike Florida or California who are pro consumer. Your State is anti-consumerism when it comes to protecting the citizens.

You can go to "appraisal under policy" its contractual in the policy "conditions". One of your roofers can be your appraiser and represent your interest before the umpire. But you will have to pay half of the umpire fee ($1500). Appraisal process almost always gets you more money, in this case it likely will trigger a covered claim. The cost for appraisal is usually $3000-4000 when all is done and said.  So that might not be feasible on smaller claims.

If you demand appraisal, the carrier is mandated to go to and pay for their own appraiser and half the umpire cost.

I would suggest contacting a claim advocate/ public adjuster and any good one will give free consultation and should be able to recover on your claim for a fee of 10%-15% . Getting 85- 90% of your claim paid is better than nothing. If they dont make a recovery there is never a charge to you.
 
Good Luck
The Claim Advocate

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