I am often told how amazing it must be to make a living as a writer. My reply is always “how would I know,” I hold down two other jobs just to keep me and my art alive. On any given day you will likely find me on a roof doing what other members of my family have done for many years, actually roofing. Or on slightly better day’s you’ll catch me at the engineer’s office writing technical assessments so lawyers and insurance companies can understand how destructive wind and hail can actually be.

Over the past three years, our area has seen its share of damaging weather, where many property owners have dealt with the claims process for the first time. Up to that point most homeowners think that the insurance thing was all about teleporting nice people in red sweaters to the scene of the claim portrayed as your agent, or a deep and reassuring voices with outstretched hands. However in the real world most states have laws prohibiting insurance agents from acting as claims adjusters or being involved in the process as to avoid unhealthy conflicts.

Unfortunately for the property owner, the larger national companies with local storefronts have now been encouraging their local agents to interfere in the claims process and … You’ve guessed it, provide an incentive for the agent to interfere. It has become so apparent to service providers such as myself that we routinely warn homeowners to, “Call the toll free claims number and not your local agent.” Furthermore, prepare yourself for a second field adjustment because the first adjuster may likely deny your claim.

Recently I had a homeowner insist on calling his close friend a local agent of a national company, to file a hail damage claim. After a 30 minute session of “are you sure and you should have another roofer look at it,” the agent was convinced to call in a claim. The first adjuster ruled as expected, a quick denial after spending more time to set up the ladder than to do an actual inspection. I told the homeowner to ask for another adjuster and call it in to the toll free claims number. Next, you guessed right again, he received a call from his agent many days later with, “let’s bring in another roofer for a second opinion.” How do you tell a man as he watches all of his neighbors receive new roof’s that he picked the wrong insurance company 36 years ago?

However, it can get worse. I did a “second opinion” inspection for a client recently and just as the storm chaser who’d knocked on his door said, he had hail damage. Once again my instructions were ignored and he called his local agent directly. After a little resistance he was called by a company adjuster and an appointment was set. I met with the homeowner and the adjuster asked to point out the damage. Now understand this roof had many black hail marks as well as dents in the soft metal areas. The homeowner pointed them out from the ground. The adjuster called it a factory defect, and the “tar balls” might “weather out” by next year … claimed denied!

As the adjuster was packing up the homeowner asked me about the next step and I explained the process of asking for another adjuster. At that point the adjuster asked me for a card and explained that if I continued to make the homeowner aware of his rights that I would be placed on “The List” and be flagged as a contractor. I kept my cool but I can’t say the same for the homeowner. The homeowner spent an hour the following afternoon talking to his agent about sending another adjuster, to which the agent explained he needed to give the damage time to “weather out” and file a new claim.

Well guess what folks, these “local agents” will receive a cash bonus for their deeds because they deferred claims payment to another year. They have been encouraged systematically to circumvent the system. Interestingly, these two competitors hired the same consulting firm, McKinsey and Associates of New York, to better their bottom lines. Both were instructed to deny more claims, delays claims and defend these practices as long as possible to grow their bottom lines. It has proved successful for both companies.

Since receiving this advice one of these companies has attained a 42 percent claims to premium payout ratio. This far exceeds the 60 percent ratio described as normal or profitable. This company was recently ordered to return $352 million in over charges to its Texas policyholders and in addition pay another $6.1 million in unfairly handled claims. These two companies hold the #3 and #4 position in a poll of the Ten Worst Insurers and both share a lower favorable than unfavorable rating in another poll. Oh, and as far as where the property owners stand? We all agreed they should get a second opinion and both have received favorable quotes from local independent insurance agents.

 

Smokey Burns lives in Waxahachie. He is a noted creative writer, singer/ songwriter and mentor to aspiring young artist. He is the author of ‘Stormy and the Christmas Runt’ set to release soon. Please contact him at Smokeyburnstexas@gmail.com.