OP should call his states insurance commisioners office with a simple
question, do insurance paid for repairs need to meet current building
code?

My experience says it does.....

On 3/25/2013 9:41 AM, bob haller wrote:
OP should call his states insurance commisioners office with a simple
question, do insurance paid for repairs need to meet current building
code?

He's been told that innumerable times to check and see what is in place
in his jurisdiction, yes. So far, no indication he's done so.

But, in the end, it will be what his specific policy terms are that will
have final say-so, I expect.

My experience says it does.....

Your experience is dated. See earlier posted links and DAGS on 'law and
ordinance' rider/policies.

As pointed out there and AFAIK at this time in the US only FL has state
law that mandates that new policies contain the clause/coverage by
default. If it's been incorporated into statute/regulation elsewhere,
it's recently.

And, as noted, it seems it started being a tactic after the spate of
gulf coast disasters and it's only after that that FL instituted their
reg's/laws. I'm pretty sure one eventual side-effect of Sandy will be
to cause such to happen in the NE as well.

--

On 3/24/2013 7:07 AM, wrote:
On Mar 23, 2:39 pm, wrote:
....

There's a (I think very slim) chance an adjuster is being overly zealous
here,

Just a slim chance? The same adjuster that looks at a wall with
7 windows and two doors and takes out the area for them because
they don't have to be painted, then applies a cheap per sq ft painting
cost? Any painter knows that cutting in around all those windows,
doors ADDS to the cost instead of decreasing it. The same
adjuster that says it only takes one coat to paint water damaged
walls and ceilings? The same adjuster that says that a power attic
roof fan with ripped up top can be fixed by buying a new top for it?
You ever see those sold? For a 25 year old fan? That adjuster and
insurance company?

Again, yeah, that one....

One other comment intended to make on the above point.

Be completely clear there are two different issues here--lowball rates
for covered repairs will be much more easily contested and while I
understand it's irritating and frustrating, don't get too bent out of
shape too soon over them. That's the kind of the thing independent
adjustors or tradesmen can help with and do all the time successfully.

The larger issue that has been the subject of the sidebar discussion is
one of what is/isn't covered. That's the one that is strictly going to
be a legal issue first and that you really need to get factual into the
nitty-gritty of the _specific_ language of your _specific_ policy and
any riders attached thereto.

--

On Mar 24, 10:07Â*pm, dpb wrote:
On 3/24/2013 7:06 AM, wrote:



On Mar 23, 5:04 pm, Â*wrote:
On 3/23/2013 3:19 PM, wrote:
...

If you have replacement cost coverage, they DO have to replace it to
current code, at no cost to you. You pay your deductible - the
insurance covers the rest. Period.

...

No, not necessarily...there may be some jurisdictions that require such
riders (in the US only FL that I know of for sure at the moment) but
it's not uncommon for there to be an "ordinance or law" exclusion in a
standard replacement policy (in fact, any more it's more common for it
to be there rather than not which is why one needs to read the policy in
its entirety in the actual policy language and can't rely simply on the
general description to know of what is/isn't actually covered).

I have no idea about Canada, specifically...wouldn't surprise if it were
a reqm't there.

http://www.adjustersinternational.com/AdjustingToday/pdfinfo.cfm?pdfI....

...

Here's a case that was litigated in Colorado about this exact issue
with Allstate. Â*Allstate tried to claim the exact same thing, that
replacement
cost coverage only meant they would pay for a replacement house that
could not be legally built because current codes required some things
beyond what was required when the house was originally built. Â*The
first court agreed with Allstate and you guys. Â* The appeals court
reversed the whole decision and agreed with the plaintiff and my
interpretation, ie that replacement cost coverage means the insurance

...

Although defendant cites cases that have reached the opposite result-
some interpreting €œequivalent construction€� to preclude the cost of
building code upgrades and some finding the exclusion for building
codes applicable-most of those cases involved policies that also
included language that the insurer would pay replacement cost €œwithout
allowance for any increased cost of repair or reconstruction by reason
of any ordinance or law regulating construction or repair.€� €‚ See

...



Here, however, no other language in the policy would negate the
reasonableness of interpreting the €œequivalent construction for
similar use€� limitation as contemplating similar functional utility
and thus to include the cost of complying with regulations necessary
to render plaintiff's house habitable.

Well, we're back to what I've said all along--in the end it will come
down to the details of what your policy says and, specifically, whether
it does or does not have an exclusion or not. Â*It's why I said there was
(I figure probably slim) chance it's an overly zealous adjustor but I
figured it was likely the adjustor knows what the policy he's adjusting
against actually covers as the better odds.

And, then if it doesn't and the adjustor still doesn't want to give and
your personal agent won't help then you have the choice as to whether
it's worth the legal battle to fight or not.

But the above judgment wins on your side because the particular
litigant's policy did not have the exclusion not because it's a general
principle in all cases.

Uh, no....

"Defendant moved for summary judgment, arguing that the policy
unambiguously excludes coverage for required building code upgrades
and provides only for the cost of returning the house to its prefire
condition, building code violations notwithstanding. "

It did have the exclusion. And the court agreed with my
iterpretation:

€œExclusionary language that conflicts with the objectively reasonable
expectations of the insured is not enforceable, even if a €˜painstaking
study of the policy provisions would have negated those expectations.
€� €‚Tepe v. Rocky Mountain Hosp. & Med. Servs., 893 P.2d 1323, 1328
(Colo.App.1994)(quoting State Farm Mut. Auto. Ins. Co. v. Nissen, 851
P.2d 165, 168 (Colo.1993)).



Â*As always, in law, the particular facts will
pertain on the particular case and slight differences in those can
change the outcome.

I'm hoping you'll come out whole; just warning that it isn't a foregone
conclusion depending on the circumstances.



Yes, I hear what you're saying. And if you go back to how this
all started here, I listed a number of things where the insurance
company is low balling and trying to weasel away. Not paying
for ice damming material was just one example. And in this
case, it's not worth fighting over, because it doesn't amount to
that much of the total claim. It's probably $400 or so. That's
real world price, could be $200 in their pricing.

I'll give you another example. I had an old couch up in the loft.
It got some water on it, and there are stains that won't come
out. I do have replacement cost coverage, right? They gave
me $200 for a 16ft sofa.

On Mon, 25 Mar 2013 07:41:50 -0700 (PDT), bob haller
wrote:

OP should call his states insurance commisioners office with a simple
question, do insurance paid for repairs need to meet current building
code?

My experience says it does.....

Of course they have to meet code. But that does not mean they have to
pay for all of it. They only pay what is covered. Did you read the
policy? No one here has so anything we say is speculation.

Ultimately the adjusters job is to settle claims as cheaply and
quickly as possible for the company...

I have delt with some, they like fast and cheap/

I still believe they MUST meet and pay for code requirement upgrdes,,

On Mar 25, 10:03*am, dpb wrote:
On 3/24/2013 7:07 AM, wrote:





On Mar 23, 2:39 pm, *wrote:
On 3/23/2013 12:54 PM, wrote:

On Mar 23, 12:13 pm, * *wrote:

I think the fundamental disconnect here is that you are
looking at the insurance company's obligation as replacing
a bunch of pieces, individual components. *Shingles, nails,
wiring, plumbing, etc. * It doesn't work that way. *If for
example I had a house that burned up, with replacement
cost coverage I'm entitled to a new house that has the
same functionality as the old one. *That is a house with the
same square footage, same number of rooms, *that
has a kitchen bedroom, etc. *The fact that today more
insulation is the min to code, and that gfci, afci are
required, ice daming for the roof, etc and that you can't
replace it without it isn't my problem. *Without doing that
I have no replacement house period.

_I_ think the disconnect here is that you're looking at the insurance
company's obligation to have provide a level of replacement beyond that
of the original building condition. *It doesn't work that way.

See previous comments explaining more about why and how to deal with it
going forward...

There's a (I think very slim) chance an adjuster is being overly zealous
here,

Just a slim chance? *The same adjuster that looks at a wall with
7 windows and two doors and takes out the area for them because
they don't have to be painted, then applies a cheap per sq ft painting
cost? * Any painter knows that cutting in around all those windows,
doors ADDS to the cost instead of decreasing it. *The same
adjuster that says it only takes one coat to paint water damaged
walls and ceilings? * The same adjuster that says that a power attic
roof fan with ripped up top can be fixed by buying a new top for it?
You ever see those sold? *For a 25 year old fan? *That adjuster and
insurance company?

Yeah, that one...

What you've not provided is any specific details on the policy, your
relationship w/ and support (or lack thereof) of the agent, etc., etc.,
only your (understandable) frustration based on what you believe should be.

There's been much good advice given but little sign of follow-up (or at
least relating the results of any).

I'm not going to fight each issue one at a time. I'm waiting
until I can address them all with them at the same time,
as a final settlement.



I'd reiterate what I've said earlier and then look into the independent
adjustor as others have suggested.

I looked into it a bit. Big problem is that the whole claim is up
to $10K. So, it's not a big enticement for any adjuster. I
called the two local ones that I could find and both are not
taking any new clients. The person on the phone at one of
them gave me advice along the lines that I'm probably better
off dealing with the insurance company myself. Sounded like
they were not having a lot of luck with the insurance companies
themselves.



*Do you know how this adjustor got
assigned?

Allstate picked them. What their internal process is, who
knows.


Is he/she as I suspected an out-of-area itinerant
specializing in disaster-area adjusting? *They show up here in hordes
like locusts after large hails and are, indeed, a plague I will agree.

Yes, from TN. And that I think is part of the problem. An
adjuster that lives in the NYC/NJ area has a better understanding
of what things cost. I'm sure they still have the same per sq ft
costs loaded, but if they see a paint job comes out to $1100 and
they know from personal experience there is no way in hell it
can be done for that, I think they are far more likely to go back
and do some fiddling with line items within their control to make
it come out right. After a lot of complaining, I finally did get
the adjuster to pay for two coats, after insisting all along that
they never would. Even with that, it's still $1000 less than the
lowest quote and I've gotten about 6 now.




The thing is that you need to get factual first on what your policy does
indeed say rather than just repeating that what it is that you think it
_should_ say. *I know I'm repeating myself but it doesn't seem to be
getting through...


One problem with that is that I can't find the damn thing at
the moment. But it doesn't matter at the moment, because my
strategy right now is to address all the remaining issues at
once, later.

On Mar 26, 12:40*am, bob haller wrote:
Ultimately the adjusters job is to settle claims as cheaply and
quickly as *possible for the company...

I have delt with some, they like fast and cheap/

I still believe they MUST meet and pay for code requirement upgrdes,,


Bob, I agree with you in concept. The way you and I see
it, if you're paying for replacement cost coverage and
your bedroom burns down, the insurance company should
be responsible for paying for a new bedroom that is the
same size, same functionality as the old one. That code
now requires arc fault, more insulation, ice damming on the
lower roof, etc, is their problem. You paid for replacement
of a bedroom, they have to replace it.

But DPB is right that the clever insurance companies have
exclusions in most policies that say they don't have to pay
for it. Or at least they think it means they don't have to pay
for it. Did you see that Colorado case I posted the link to?
The policy in that case had exactly that, an exclusion.
The house burned down and Allstate said they were not
required to pay for things now required by code.
The lower court agreed with the insurance company.
On appeal, it was reversed, because the appellate court
cited case law where if the overwhelming verbage of
the policy would lead a reasonable person to believe that
it was covered, tricky exclusions can be ignored. They said
the overall policy was clearly to put the homeowner back
in the position they were in pre-fire. That means they
had a bedroom then, they are entitled to a bedroom now.
The fact that some code changes mean it costs more
does not mean the homeowner winds up in any better
position than they were pre-fire. They still only have
a min code bedroom. That was the essence of the finding.

And following that, they probably crafted the policies better
so as to still be able to deny it. In short, at best it's a grey
area and could vary from state to state depending on the
laws there, the court rulings, etc. And in my case it's a
couple hundred buck, if the insurance company won't
cover it, it's not worth a big fight. BUT, I think it is worthy
of discussion for two reasons:

1 - I don't think it's right

2 - Anyone that has replacement cost coverage should be
aware of this. Worst case, let's say you have a house that
you've been paying for replacement cost on for 25 years.
It covers the house to $300K. The house burns down.
The insurance company could total up what they say it
takes to build a new one, that isn't up to code. Suppose
that can be done for $250K. So, even though the policy
says they will pay to replace the house, they give you a
check for $250K and refuse to pay the other $50k,
because that is for code required items that were not
required when the original house was built.

On 3/26/2013 8:09 AM, wrote:
....

I'd reiterate what I've said earlier and then look into the independent
adjustor as others have suggested.

I looked into it a bit. Big problem is that the whole claim is up
to $10K. So, it's not a big enticement for any adjuster. I
called the two local ones that I could find and both are not
taking any new clients. The person on the phone at one of
them gave me advice along the lines that I'm probably better
off dealing with the insurance company myself. Sounded like
they were not having a lot of luck with the insurance companies
themselves.

....


Is he/she as I suspected an out-of-area itinerant
specializing in disaster-area adjusting? They show up here in hordes
like locusts after large hails and are, indeed, a plague I will agree.

Yes, from TN. And that I think is part of the problem. An
adjuster that lives in the NYC/NJ area has a better understanding
of what things cost. I'm sure they still have the same per sq ft
costs loaded, but if they see a paint job comes out to $1100 and
they know from personal experience there is no way in hell it
can be done for that, I think they are far more likely to go back
and do some fiddling with line items within their control to make
it come out right. After a lot of complaining, I finally did get
the adjuster to pay for two coats, after insisting all along that
they never would. Even with that, it's still $1000 less than the
lowest quote and I've gotten about 6 now.


The thing is that you need to get factual first on what your policy does
indeed say rather than just repeating that what it is that you think it
_should_ say. I know I'm repeating myself but it doesn't seem to be
getting through...


One problem with that is that I can't find the damn thing at
the moment. But it doesn't matter at the moment, because my
strategy right now is to address all the remaining issues at
once, later.

The agent certainly should be able to furnish one in a heartbeat.

I'd forgotten the carrier; I've never dealt w/ Allstate but my sense is
they're one of the PITA outfits. Our carrier has always been the Farm
Bureau in the state of current residence and while they may be a little
higher premiums, I've never had any difficulty in the claims process.
But, you've got to be able to qualify as member in the Farm Bureau in
most states for them to underwrite which is generally not possible for
urban dwellings. Not that any of that helps your current problem, just
an aside...

I looked at the State Farm web site for catastrophe adjustment and there
are a couple of interesting things at the following page--nothing I
found specifically covered the question of coverage code-mandated
upgrades but the question of the depreciated estimate and replacement
coverage for personal property was...says they'll make an additional
restitution on the actual replacement cost when you supply your cost
documentation for the repair or replacement of the item.

Seems like a reasonable approach to work it out in the end--they do have
a generic paragraph about the difference between contractor estimate and
adjustment as well...they (of course) claim they have "local rates"
built into their software but rates for whom--the illegals gathered in
front of the Lowes every morning, maybe?

I didn't find any mention as noted on the Code or the 'law and
regulation' rider issue. I don't recall whether you said NJ or NY so
didn't look at state sites to see what they're saying.

I'd be on the agent, though to get on my side to at least reach the
minimum reputable contractor estimates for the physical repair work...

--

On 3/26/2013 8:26 AM, wrote:
On Mar 26, 12:40 am, bob wrote:
....


I still believe they MUST meet and pay for code requirement upgrdes,,


Bob, I agree with you in concept. The way you and I see
it, if you're paying for replacement cost coverage and
your bedroom burns down, the insurance company should
be responsible for paying for a new bedroom that is the
same size, same functionality as the old one. That code
now requires arc fault, more insulation, ice damming on the
lower roof, etc, is their problem. You paid for replacement
of a bedroom, they have to replace it.

But DPB is right that the clever insurance companies have
exclusions in most policies that say they don't have to pay
for it. Or at least they think it means they don't have to pay
for it. Did you see that Colorado case I posted the link to?
The policy in that case had exactly that, an exclusion.
The house burned down and Allstate said they were not
required to pay for things now required by code.
The lower court agreed with the insurance company.
On appeal, it was reversed, because the appellate court
cited case law where if the overwhelming verbage of
the policy would lead a reasonable person to believe that
it was covered, tricky exclusions can be ignored. They said
the overall policy was clearly to put the homeowner back
in the position they were in pre-fire. That means they
had a bedroom then, they are entitled to a bedroom now.
The fact that some code changes mean it costs more
does not mean the homeowner winds up in any better
position than they were pre-fire. They still only have
a min code bedroom. That was the essence of the finding.

And following that, they probably crafted the policies better
so as to still be able to deny it. In short, at best it's a grey
area and could vary from state to state depending on the
laws there, the court rulings, etc. And in my case it's a
couple hundred buck, if the insurance company won't
cover it, it's not worth a big fight. BUT, I think it is worthy
of discussion for two reasons:

1 - I don't think it's right

2 - Anyone that has replacement cost coverage should be
aware of this. Worst case, let's say you have a house that
you've been paying for replacement cost on for 25 years.
It covers the house to $300K. The house burns down.
The insurance company could total up what they say it
takes to build a new one, that isn't up to code. Suppose
that can be done for $250K. So, even though the policy
says they will pay to replace the house, they give you a
check for $250K and refuse to pay the other $50k,
because that is for code required items that were not
required when the original house was built.

I had missed the end result in the CO case before indeed...that's
interesting that the court did strike the exclusion down owing to the
preponderance of implied coverage to make whole. If undoubtedly help
the insured in that case to have been in what is now a very
liberal-leaning State in making the appeal.

As noted, I'm sure the underwriters' lawyers have studied that (and any
similar) decisions _very_ carefully and have wordsmithed the language to
try to ensure it will be enforceable in the future.

As you, I think it's a despicable ploy; nothing I've written previously
should be interpreted as being supportive of the idea; only that it's
definitely not a given that coverage will be automatically given to
cover additional Code or other occupancy reg's in place since the time
the original structure was built.

As noted earlier, I think there was a big problem in the casualty models
used in setting rates for catastrophic losses in that they forgot
about/essentially ignored common-cause and the magnitude of the possible
damage area affected by these events as the population and particularly
evaluations in these coastal areas grew exponentially over the years w/o
any major events. After that, they were left with such massive losses
they've resorted to whatever could to try to limit liability.

Also as I noted before, I believe one upshot of Sandy will be that
FL-like legislation will follow in the NE and along all the Atlantic
coastal areas w/ time that will mandate that policies include the rider
by default and homeowners will have to explicitly decline it if choose
to not pay the additional premiums that it will entail. And, of course,
while it will provide coverage, "there is no free lunch" and rates will
rise to cover it. Of course, they're rising anyway to cover the
problems the last few years have uncovered in the actuarial rates were
using, anyway...

--

wrote:
Any experiences with how to deal with insurance adjusters for
roof damage and interior water damage repairs, eg re-taping drywall,
painting?

This is from Sandy last fall. Had the adjuster out today. . . . ,

So, today the Allstate adjuster was here. It was something else. . . . .
,

Here's a website link that I just found today that I think will be of
interest to you:

http://www.justice.org/docs/TenWorst...eCompanies.pdf .



And, you guessed it, Allstate ranks Number 1 on their list.