An Insurance Claim is Not Like Winning The Lottery

Contrary to popular belief, property owners are not supposed to make money from a claim. BOTH contractors (the questionable ones) and property owners perpetuate this erroneous position. An estimated $80 billion worth of fraudulent claims are filed every year. Insurance companies are a "for profit" company, as one RCS member put it' "they hope to collect more in premiums in than payouts".

I am sure I'm going to get lambasted for this, since I have been only adjusting for a year or so.. I have witnessed contractors in Oklahoma and Texas attempt to fleece insurance companies. Many times "self-proclaimed" roofing hail experts attempt to document hail damage that's just not there or charge twice the amount of normal market pricing; some take advantage of the ignorance of the adjuster.

When you sit in a meeting with insurance executives and attorneys discussing a large claim and hear, "If it's hail damage pay it, if it's not, let's fight". In general, there is good faith. Insurance companies are now considering and proposing roof restoration (for flat roofs) over complete replacement to bring roofs back to "pre-loss" condition. I'm not saying that insurance companies are choir boys, but I believe that this is a cause and effect from general public distrust in the insurance industry, insurance fraud, match with property owners and contractors believing filing a claim is like winning the lotto.

Got it. Thanks for the advise!

theroofmedic Said: @ GSD no offense taken, this is the ROOFERS FORUM and not the INSURANCE ADJUSTERS FORUM. I am a lone wolf out here and know Im going to get bit.

Twill- That is so true but all that sun destroys roofs quickly! In the Arizona roofing trade you start cutting your "roofing teeth" on foam and coating. Hypalon was big to in the early 90's. Beside foam and coating, tile is huge. The heat would bake the underlayment so tile R&R's were very profitable but back breaking.. In the summer you couldn't work with them unless you wore gloves. Shingles is where I had the least experience. Believe it or not I had a harder time installing 3-tabs then dimensionals.

NICE Job Twill59- In Arizona you are required to have a Roofing contractor's License, (you have to past a knowledge, skill and business test), background check, be bonded, carry worker's comp, and have liability insurance. Contractors have to answer to the Registrar of Contractors and contribute to the Recovery Fund which was set up for consumers if they were "screwed" by a contractor. It didn't stop bad contractors or halt fraud but it did slow it way down.

@ GSD no offense taken, this is the ROOFERS FORUM and not the INSURANCE ADJUSTER'S FORUM. I am a lone wolf out here and know I'm going to get bit.

when its all said and done, there is no one to blame BUT the insurance companies, from the companies themselves, to the adjusters. The insurance companies set the prices they will pay.....regardless of the cost, be it too high, too low, or right with the current prices in that area. then you have the adjusters trying to let the job go for more or less of the actual cost. it is the price of doing business. The insurance companies need to involve themselves in their "total" business, which includes finding the right cost of doing the work in that area, AND finding the right contractor to work with. They can not rely on the contractor to do their part of the business, because, contractors are in it to make a profit also, just like the insurance companies. Now, throw in a homeowner that is trying to get as much as possible for their $$.

So you have 3 entities trying to gain as much as possible for themselves in the negotiation and service. BUT one of them has the final say in the whole service, the insurance company.

Now this is the sticky part, the Insurance company has the possibility of losing a customer if the customer doesn't feel they are treated fairly by the company. But throw in the mix a contractor that wants to make a profit and will sometimes charge as much as possible for the job. regardless of what the contractor says, it is still the job of the insurance company to write the check at the end of the day.

This is a problem in all walks of life, from retail, food industry, construction, factories, etc. but the problem started in this industry with the insurance companies "giving away" roofs years prior because of wind, hail, storms, etc. mainly the adjusters. and that can be attributed to many reasons from being nice to making a bigger commission.

and no offense to theroofmedic, but the insurance industry is now blaming the problem on everybody else in the negotiation and deal. They write the check at the end of the day, it is their job to fix the problem they made years prior with the way they did business back then.

Its part of doing business.

While I may have not roofed The Alamo nor was a licensed insurance adjuster when Sam Houston filed the first hail claim in Texas, it didn't take long to realize the problem and the challenge. Again, that was the original point of the article and the opening sentence;

"Contrary to popular belief, property owners are not supposed to make money from a claim. BOTH contractors (the questionable ones) and property owners perpetuate this erroneous position."

Tim is 100% correct; "There are no innocent parties here when we're talking about carriers, insureds, and roofers."

But, whether you have been roofing since the time Sam Houston became president of Texas or just starting when The Houston Rockets won the Championship, established or new and everything in between, if you "eat deductibles" or submit over priced proposals to insurance companies, you are part of the problem.

There it is.

GSD Said: Regardless of all that is being said here, the customer or homeowner DOES feel like they won the lottery with a large insurance claim for their roof. and the finger is pointed in everybody elses direction, roofer, adjuster, insurance company, etc. the homeowner won the lottery.

B) :) :) B) Deep Down In Florida Where The Sun Shines Damn Near Every Day

GSD, I FULLY AGREE, That is the perception! EDUCATING the customer on his or her responsibility according to their policy and the law is key point. But we all know that is easier said than done. What makes it even more challenging is the large number of contractors offering free roofs and implying that a property owner can actually make money or profit from a claim, it perpetuates the perception. It makes it harder for legitimate contractors in the insurance process to take the time to educate their customer while just behind them is a slick roofing sales guy saying, "Mr.& Mrs. Property Owner, "I can get you a virtually FREE ROOF!"

Even look how roofing sales people are recruited, "Give Away FREE Roofs and make $$$!" Below is a page from a book that kind of exposes this sales tactic and breaks the ground for good roofers to educate their clients or prospects. It's a challenge but I think eventually good contractors can help change the perception.

Regardless of all that is being said here, the customer or homeowner DOES feel like they won the lottery with a large insurance claim for their roof. and the finger is pointed in everybody elses direction, roofer, adjuster, insurance company, etc.

the homeowner won the lottery.

Regardless of all that is being said here, the customer or homeowner DOES feel like they won the lottery with a large insurance claim for their roof. and the finger is pointed in everybody elses direction, roofer, adjuster, insurance company, etc.

the homeowner won the lottery.

Tim does have a point when it comes to industry relationships; I have been approached to umpire insurance disputes by roofers who know me, hoping that I would side with them. Again, kinda makes my point about dishonest roofers.

If there are adjusters who make backdoor deals, "cover me on this one" it is a violation of their ethics code and can jeopardize their license and if found true it will be revoked. An adjuster is required to take ethics/consumer protection CE courses to maintain their license.

Between the insurance industry's reputation, dishonest contractors and property owners expecting huge winnings from insurance claims this definitely creates an environment for conflict and fraud.

It also makes it hard for good honest roofing contractors who play by the rules... :(

Interesting way of looking at insurance fraud. With that being said, according to TDI Each year, insurance fraud costs consumers an estimated $150 billion, an average of almost $1,000 per family in additional insurance premiums. Even our own Texas insurance commissioner Ms. Kitzman stated, "Texas has one of the highest rates of fraud in the roofing repair industry!" So every time someone "pickpockets" the insurance company it costs all of us. Just something to think about.