Months after ice storm, homeowners struggle with insurance claims – NBC 5 Dallas-Fort Worth

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More than five months after the polar vortex and the February electricity crisis crippled the state, some North Texans say their homes are in poor condition – despite having insurance coverage.

Read on to find out what consumers can do to deal with insurance matters and litigation.

“We want to go home”

When the power went out, the pipes froze in Brenda Kirby’s house in Garland.

“We had let the water run. We opened the cupboards, tried to do whatever we were supposed to do, ”Kirby said.

Still, water from a dining room sink spilled out and spread throughout much of the house.

“From the back of the house to the front of the house it was wet,” Kirby said.

Kirby said his insurance company offered about $ 46,000 less than his contractor expected to repair the damage. As a result, Kirby said she still lives in a hotel room.

“We don’t ask for insurance to send us on a trip, to buy us a new car, to add a new wing to our house. We want to go back to our house, ”Kirby said.

Kirby hired an insurance adjuster. Public adjusters are licensed in Texas to process claims against policyholders for a fee – typically up to 10% of the final insurance settlement.

“We’ve made all the damages we can and we’ve made all the arguments we can, but the insurance company has set a pretty hard line,” said Adam Brenner – the public claims adjuster hired by Kirby.

Brenner said the insurance company and Kirby had thousands of dollars of variance on the cost of replacing kitchen cabinets. Kirby also wanted to replace the tiled floors in the dining room and kitchen, but the insurance company offered to pay for cleaning the floor and replacing a broken tile during the restoration work.

“There was undoubtedly water under the ground as a result of this loss. Unfortunately, the insurance adjuster simply was not able to resolve this issue as part of the claims process, ”said Brenner.

“They won’t answer my calls”

Jena Gile said she was at her wit’s end when she reached out to NBC 5 Responds. After a pipe burst inside her Parker County home, Gile said she racked up just over $ 12,000 in spending on her credit card.

“My house is completely destroyed, they are not answering my calls. I don’t know what to do, ”Gile said.

Gile said she couldn’t get clear answers on what was covered and what was not.

“They sent me a check once and I said thank you very much. What is it for? “Says Gilles.” I don’t know what I’m still taking out and what has been reimbursed. “

Gile has a policy with Maison Insurance – which is owned by FedNat. Days after NBC 5 asked FedNat to answer Gile’s questions, Gile said a new insurance adjuster called with some promising news.

“I finally got a reminder and they said they were going to start getting things done. They sent another check to start work, ”Gile said.

In an email to NBC 5 Responds, a FedNat spokesperson wrote: “It is FedNat policy not to publicly discuss individual claims, but the company has ensured that the claims department has contacted the claims department directly. customer to resolve questions.

The evaluation provision

NBC 5 Responds asked Kirby’s insurance company State Farm about Kirby’s claim.

He told NBC 5 Responds he couldn’t talk about details due to its privacy policy. State Farm wrote, in part: “When a claim is made to State Farm, we thoroughly investigate the loss. A final decision on a claim is determined by the facts of the loss and the results of the investigation, and we treat each claim on its own merits.

State Farm has also highlighted the appraisal provision in its policies – which can be invoked by either party to resolve disputes.

“The assessment process is normally a binding agreement,” said Camille Garcia of the Insurance Council of Texas – a professional group that represents many insurers in Texas.

Garcia explained that the consumer and the insurance company each hire an appraiser to assess the claim, then bring in a third-party arbitrator to make the final decision.

“You paid for that appraiser to come in, you shared the cost of the referee, the referee’s decision is the final decision,” Garcia said.

Garcia said the assessment could offer an alternative to going to court – if the dispute is over the value of the claim. The evaluation would not change the boundaries of the policy.

“If you don’t have mold coverage in your policy, that appraiser or adjudicator isn’t going to come and say that mold coverage is now suddenly there,” Garcia explained.

“The covers have to be determined. Then it’s really the cost of that damage and the repairs that the assessors and the arbitrator will look at, ”Garcia added.

The Kirby family said they are now weighing their options in hopes of returning to their home.

“Why do we have to fight for something we’ve paid for for years? Kirby asked. ” It does not mean anything. We have contributed to State Farm since the 1980s and we are treated like that.

Consumption options in Texas

As of July 31, the Texas Department of Insurance said it had registered 1,028 complaints related to the February ice storm. Most of the complaints, 689, mentioned plumbing or water damage.

“I think we’ll hear from more people in time. We are just when, after the winter storms, people have gone out of their way to try and work with their insurance company, ”said Ware Wendell, executive director of Texas Watch.

Wendell said consumers can see very different responses in the aftermath of a disaster – depending on your insurance company, your policy, the endorsements, even the adjuster who shows up to handle your claim. .

“Insurance companies can cancel those claims and give you a dime. In doing so, many consumers give up, ”said Wendell.

One option for policyholders is to file a complaint with the Texas Department of Insurance or to start by calling the TDI consumer helpline at 800-252-3439.

“Each case will be unique and whenever you think the company is not treating you fairly, we want to know,” said Ben Gonzalez – spokesperson for TDI.

Gonzalez said the TDI will ask the insurance company for proof that they are following your policy and Texas law.

“What the company doesn’t want to happen is having multiple instances where we ask them what’s going on here, because that establishes a pattern of issues with a particular company,” Gonzalez said. “This may prompt us to take a closer look at the operations of the company. “

Out of 1,028 ice storm-related complaints, TDI said nearly half of consumers, 479, would get extra money after TDI’s involvement.

What to know before the next disaster

Before you have to file a claim, document your damage and your communication with your insurance company. If you are speaking by phone, send an email highlighting what was discussed to create a written debrief.

If you have any damage, keep evidence like the broken piece of pipe or part of the carpet that was damaged. Read your policy carefully and understand what you need to save. The insurance company may ask to inspect these items.

Texas Watch offers advice here.

At least once a year, take a video tour of your home. Use your phone and record a video as you walk around your house, opening drawers and closets. Document the model numbers and serial numbers of valuables. Save the videos to the cloud or email them to yourself in case your phone gets destroyed.

If you’re shopping for insurance, the Bureau of Public Insurance Advice has a comparison tool here.

If you are unable to find a solution with your insurance company and you need to find a lawyer. The State Bar of Texas has a referral service here.

NBC 5 Responds is committed to investigating your concerns and getting your money back. Our goal is to provide you with answers and, if possible, solutions and resolution. Call us at 844-5RESPND (844-573-7763) or complete our customer complaint form.

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