Are counter claim adjusters who come to your house after a denied claim legitimate?
After a major hailstorm/windstorm that damaged a lot of property in my area, My roof claim was mostly denied by my insurer (Allstate), saying that the damage present took place over time, older roof, etc. I ended up with a check for $65.
A counter claim adjuster called me a month or two later. He said that my roofing guy called him, and that the roofing guy thought I had a good claim. The counter claim adjuster said that he would inspect my roof, and if looked like I had a good claim, his company would file the paperwork at no cost to me. He said that if I do get insurance money, I would have to give him 10%.
He came to look at my roof and showed me photos of different parts of the roof that showed hailstorm and windstorm damage. He said that he thought I had a good claim and that I deserved more money to repair (the house across the street got a totally new roof, as did many in my neighborhood).
He said that he would submit the paperwork to the insurance company. He said that it was likely that the insurance would call me and ask me a lot of questions.
So, are these kind of outfits legit? Will this affect my relationship with my insurers in any way?
I have heard of this sort of animal but I don’t have any experience with them. That said, if he’s taking a hunk of your claim payment, then presumably he is taking a hunk of something you should have been able to get from your insurer yourself. There are no secret handshakes or magic words he gets to use that are forbidden to you. If Allstate would change their minds based on something he says, then you should be able to get the same result.
In my experience it’s hard to differentiate between new & old storm/hail damage. Allstate can say it was from multiple events, but ask them how they can prove that for sure. It’s your roof, you are in the better position to say what sort of condition it was in at any given time. Would they be absolutely confident explaining their position to a jury in the event you decided to pursue them for breach of contract, to recover the amount they owe for the claim plus a statutory punitive amount? Play that card, and see how they respond.
You’re not far off, although once a case moves into litigation there is really no substitute for having a lawyer filing motions, correctly interpreting court procedures, and formulating courtroom strategy. Outside of that, as in the case of simple to moderate injury cases, it’s highly debatable whether the attorney actually does any net good for their client. But above all, in the case of a damaged roof which is what we’re discussing here, ZERO harm can come from making the insurance company explain itself to its policyholder, or in assuming an attention-grabbing posture to encourage them to deal fairly. If it doesn’t work, then what the hell and see if the independent can do any better.
My question is, did this counter-claim adjuster show up out of the blue to offer help, or did someone, like the roofing company, send him? If he wants to help you out of the goodness of his heart, I would at least, get a second and third opinion, or send him packing.
Call the roofer. First verify if he sent the guy. He should have talked to you first if so.
Second, see what he thinks about the storm damage. Did he think you had a claim? When I had storm damage, the roof inspector took me up on the roof, showed me what he saw, and talked me through how the insurance adjustor would be measuring things. They use standards like x number of impacts per tile is repair, Y number is replace. The day the adjustor was there, the inspector came back out and walked around the entire house with us and pointed out things that the adjustor had not noticed. He was great. I also learned a lot from him.
If the roof inspector thinks that you have a claim, talk to your agent about appealing the denial. You’ll need support from the inspector, but it’s certainly possible it could happen. I don’t think you need Mr. Counter Claim though.
ETA: if he did send the guy without asking you, I would consider getting a second opinion on your roof from someone else. It sounds fishy.
Sometimes these guys just cruise the neighborhood after a big storm, asking people if they were satisfied with the insurance company’s response. There’s nothing inherently illegitimate about them; they’re just a second opinion. Hiring them on contingency to pursue an appeal is essentially an intermediate step, less confrontational than hiring a contingency-fee lawyer to threaten suit (or actually to sue). The idea is that either their expertise will find a way to convince the insurer that its own adjuster overlooked something, or at least to signal to the insurer that there is enough room for disagreement that it is in their interest to settle with you rather than pursue a disagreement further.
Certainly, there’s no way for anyone here to tell whether this particular guy is reputable and competent, or whether the damage to your roof warrants this kind of appeal.
Also, there is no way for any of us to opine responsibly on how your insurance company might react to being challenged, and whether any risks in doing so might outweigh the potential rewards.
Further disclaimer: I am not your lawyer, and this does not create a lawyer-client relationship. This is just anonymous chat and should not be relied upon.
I had a claim for roof damage after a 70mph wind. The insurance agent said they would pay for a square of roofing. I told him the roof would look like shit with new shingles and old ones.
They agreed to pay for one half of the roof. Two sides were undamaged. It was a great deal because the first layer was shake and two composites after. Local code says no more layers. They had to remove the shake and put down sheating, roof felt, then new composites.
I paid for the other two sides. New roof at half price.