I'm a public adjuster and I hate wear and tear. The good news is in every policy it states that they don't cover wear and tear but they do cover ensuing damages. Which, means they will/have to all the damage that was caused by the item that wore out. They wont pay for the pipe but they have to pay for everything else!!
This guy knows his stuff! I thought he was going to leave out #5 which is huge. I sell Water Mitigation and Mold Remediation contracts and work with insurance adjuster's daily. If the client does not have a sump pump coverage endorsement (usually 5k cap) on their policy, then they will not be covered if water backups into the basement from a sump pump failure. Also, the client will not be covered if their outside drain gets clogged and backs up into the basement without backup coverage endorsement. By far Allstate is the worst when it comes to not fully covering a loss that should be covered fully. I'm in the north and he is correct about Mold Remediation. The few insurance companies that cover mold usually have a 5k cap. Most companies don't cover mold because they use it as an excuse to deny your claim in the first place as Shane mentioned. Also, for people that are thinking about buying what I call new/old homes meaning the home was fully remodeled but was built in the 1900's, the main sewer line is just as old and will eventually break, belly, or get penetrated by tree roots. Your homeowner's insurance will not cover any outside excavation unless you have that endorsement on your policy. If your insurance company does not have that option, then I recommend finding supplemental insurance that does because my company charges on average 10-20k for MSL (Main Sewer Line) excavation. When thinking about buying a new/old home, pay to have the sewer line inspected with a camera before you buy because this is not one of the standard inspections that is free before you buy, for obvious reasons. If the home has a pvc cleanout on the front lawn or closer to the home (which is ideal) is an indication that part or all of the MSL on the property side has been replaced but still get that camera inspection.
I do not recommend Lemonade Insurance Company. We paid $3800 a year for home insurance, but our claim for a water pipe burst was denied. The adjustor came and took pictures of our bathroom and I kept telling him that our ceramic wood in the kitchen was lifting and he just kept ignoring me and focusing on the bathroom which is tiles. #Lemonade Insurance Company. #Terrible #homeinsurance
Hey, thanks for the comment! I'm stoked that you liked the way I phrased that question. It's all about finding that perfect balance to grab people's attention and make them think.
I have 9 yrs in my house there’s plumbing issues with the 3 restrooms. I have called 3 different companies to come and checked the leaks and they don’t find the problem. I have nightmares about the leaks. Cause if I remodel it will be so expensive and if they find the leak it will be a lot more.
What about if the homeowner don’t wants to start the mitigation because they feel the adjuster or the insurance will not pay for the mit job and the repairs? I mean they always say I want to wait for the adjuster to be here first 😢
What is your NPN #. If insured doesn't know when then it is not the carrier responsibility to determine date of loss policy states in most states that insured is responsible to provide date of loss. You can not by statue assist insured in submitted claim unless you have adjuster or agent license.
You should refer to the date of loss to be the date that you arrived for your inspection. Anything other than that is simply guessing - and it will get their claim denied too
On one hand you’re saying I should tell them I don’t know where the water came from but in another hand I still have to know so that I can mitigate correctly, and classify the water loss. Kinda confused on how to bridge that gap when talking to insurance. 😂
In situations where you don't know where the water is coming from, pay attention to the location of the leak and the nature of the leak and also ask the client questions like whether or not they recently plunged their toilet? which could indicate they accidentally moved the wax ring out of place causing the leak which is more of a constant drip as opposed to a constant stream usually indicates a supply line leak. Also, ask to see the plumbers report if they have one or follow up with the plumber. The cause of loss can be general when talking to insurance initially when filing the claim if the repair has not been made yet which is fine ie, "leak coming from the bathroom above causing damage to the ceiling below" "plumber is still diagnosing for repair" The insurance adjuster that's assigned, usually don't contact the insured or yourself until 24-48 hours later and by that time the repair should have been made so you should have more information by then. Whenever possible try to communicate with the plumber to go over what they will write in their report because some insurance adjusters will ask for the plumbing report to look for a reason to deny your claim. I have not been in the industry for that long but every time you lose money from a claim being denied, you learn fast lol and I work with all insurance companies besides Travelers because they suck when it comes to paying out.
the point is this... it is wet, it needs to be dried. The more detail you give the more likely the claim can get denied. Remember that a policy is 65 pages long so they write hundreds of scenarios where it won't be covered
I just was denied from my water claim as they claimed I didn’t tell them I had a previous claim less than 3 years ago but they still gave me policy and they said if I told them which I believe I did they wouldn’t have accepted me as a customer please someone help me to get my claim paid
I’m confused. Is this a new water damage claim or are you trying to repair a loss that happened 3 years ago? If it’s a new loss, what did or didn’t happen 3 years ago shouldn’t matter. There’s many reasons a homeowner doesn’t file an insurance claim. Maybe it was small and you dried it out yourself because you didn’t want to file a claim on something taken care of by a few fans and have your premiums increase. The point is that if this damage is a new leak, what standard are they using to claim that the damage is from 3 years ago and not from the new leak?
This dude got to be the best mentor for Water Damage Companies.
I'm a public adjuster and I hate wear and tear. The good news is in every policy it states that they don't cover wear and tear but they do cover ensuing damages. Which, means they will/have to all the damage that was caused by the item that wore out. They wont pay for the pipe but they have to pay for everything else!!
Thanks for the clarification!
Will they cover a repipe if it's needed in building code upgrade?
@@ramonespinoza8779 I seriously doubt it.
But if it is a burst pipe save your recipe and you can get the money back after
@@ramonespinoza8779yes they will if code upgrades are in the policy. Some policies exclude code upgrades. Gotta. Check the policy
Southern California. Just filed my first water damage claim. This info has been helpful, thank you!
This guy knows his stuff! I thought he was going to leave out #5 which is huge. I sell Water Mitigation and Mold Remediation contracts and work with insurance adjuster's daily. If the client does not have a sump pump coverage endorsement (usually 5k cap) on their policy, then they will not be covered if water backups into the basement from a sump pump failure. Also, the client will not be covered if their outside drain gets clogged and backs up into the basement without backup coverage endorsement.
By far Allstate is the worst when it comes to not fully covering a loss that should be covered fully. I'm in the north and he is correct about Mold Remediation. The few insurance companies that cover mold usually have a 5k cap. Most companies don't cover mold because they use it as an excuse to deny your claim in the first place as Shane mentioned.
Also, for people that are thinking about buying what I call new/old homes meaning the home was fully remodeled but was built in the 1900's, the main sewer line is just as old and will eventually break, belly, or get penetrated by tree roots. Your homeowner's insurance will not cover any outside excavation unless you have that endorsement on your policy. If your insurance company does not have that option, then I recommend finding supplemental insurance that does because my company charges on average 10-20k for MSL (Main Sewer Line) excavation. When thinking about buying a new/old home, pay to have the sewer line inspected with a camera before you buy because this is not one of the standard inspections that is free before you buy, for obvious reasons. If the home has a pvc cleanout on the front lawn or closer to the home (which is ideal) is an indication that part or all of the MSL on the property side has been replaced but still get that camera inspection.
Glad you liked it
Great video, Shane. Possibly your best one yet!!
thanks.. glad you liked it
I do not recommend Lemonade Insurance Company. We paid $3800 a year for home insurance, but our claim for a water pipe burst was denied. The adjustor came and took pictures of our bathroom and I kept telling him that our ceramic wood in the kitchen was lifting and he just kept ignoring me and focusing on the bathroom which is tiles. #Lemonade Insurance Company.
#Terrible #homeinsurance
The jury part got me 😂 love the videos! Glad i found this page
Nailed it on the "should we stop mitigation?" phrasing.
Hey, thanks for the comment! I'm stoked that you liked the way I phrased that question. It's all about finding that perfect balance to grab people's attention and make them think.
I have 9 yrs in my house there’s plumbing issues with the 3 restrooms. I have called 3 different companies to come and checked the leaks and they don’t find the problem. I have nightmares about the leaks. Cause if I remodel it will be so expensive and if they find the leak it will be a lot more.
Love the show! Listening from Phoenix
That's a booming market
Great stuff Shane. I’m listening from Nashville. So many restoration companies mess this up for their clients.
Love Nashville!
Great info, Thanks!
Glad it was helpful!
This information is great, i really appreciated !!!
Glad it was helpful!
Anyone hear of insurance demanding plumbers report?
What about if the homeowner don’t wants to start the mitigation because they feel the adjuster or the insurance will not pay for the mit job and the repairs? I mean they always say I want to wait for the adjuster to be here first 😢
yeah but that is a sales issue to be honest. you have to coach them up to follow your lead
If they don't lay they still have to do it.
Douglasville ga
Colorado
Just filled a claim with Mercury insurance
What is your NPN #. If insured doesn't know when then it is not the carrier responsibility to determine date of loss policy states in most states that insured is responsible to provide date of loss. You can not by statue assist insured in submitted claim unless you have adjuster or agent license.
You should refer to the date of loss to be the date that you arrived for your inspection. Anything other than that is simply guessing - and it will get their claim denied too
Portland OR
welcome
On one hand you’re saying I should tell them I don’t know where the water came from but in another hand I still have to know so that I can mitigate correctly, and classify the water loss. Kinda confused on how to bridge that gap when talking to insurance. 😂
In situations where you don't know where the water is coming from, pay attention to the location of the leak and the nature of the leak and also ask the client questions like whether or not they recently plunged their toilet? which could indicate they accidentally moved the wax ring out of place causing the leak which is more of a constant drip as opposed to a constant stream usually indicates a supply line leak. Also, ask to see the plumbers report if they have one or follow up with the plumber.
The cause of loss can be general when talking to insurance initially when filing the claim if the repair has not been made yet which is fine ie, "leak coming from the bathroom above causing damage to the ceiling below" "plumber is still diagnosing for repair" The insurance adjuster that's assigned, usually don't contact the insured or yourself until 24-48 hours later and by that time the repair should have been made so you should have more information by then. Whenever possible try to communicate with the plumber to go over what they will write in their report because some insurance adjusters will ask for the plumbing report to look for a reason to deny your claim. I have not been in the industry for that long but every time you lose money from a claim being denied, you learn fast lol and I work with all insurance companies besides Travelers because they suck when it comes to paying out.
the point is this... it is wet, it needs to be dried. The more detail you give the more likely the claim can get denied. Remember that a policy is 65 pages long so they write hundreds of scenarios where it won't be covered
I just was denied from my water claim as they claimed I didn’t tell them I had a previous claim less than 3 years ago but they still gave me policy and they said if I told them which I believe I did they wouldn’t have accepted me as a customer please someone help me to get my claim paid
I’m confused. Is this a new water damage claim or are you trying to repair a loss that happened 3 years ago?
If it’s a new loss, what did or didn’t happen 3 years ago shouldn’t matter. There’s many reasons a homeowner doesn’t file an insurance claim. Maybe it was small and you dried it out yourself because you didn’t want to file a claim on something taken care of by a few fans and have your premiums increase.
The point is that if this damage is a new leak, what standard are they using to claim that the damage is from 3 years ago and not from the new leak?
San Diego ca
Perfect
Thank you so much for your kind comment! I'm glad you enjoyed the video.
Well designed commercial to sell your own product. Lame. 🙄