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.

I stand ready to prove everything I say, Nick.

I am done too. It's a waste of energy.

Nick, you're like paint. There is what everyone can see, then there's what I know is underneath.

Your vast experience seems to be a figment of your imagination. For someone who has such a lengthy and vast experience in SPF, the internet doesn't seem to know anything about it. Hmmm. Your advanced knowledge of SEO is acknowledged by The Roof Medic popping up on nearly every search that includes the word "roof," but for some reason the internet cannot find the vast prior experience you claim.

You say that Xactimate sought you out to establish SPF and coating prices in AZ, yet Google can't even seem to find your vast SPF experience in AZ or anywhere else.

I'm beginning to think you were a special agent with the CIA, carrying out top secret missions all over the world in the dark of night, and thus your vast roofing history has been wiped clean from any database. Yeah, now that I think about it, I'm sure that's it.

Nick, these games are silly. You can keep right on fooling these guys who don't know you, but I know you. I'm content to never hear your name again but you keep inserting yourself into my life. I'd prefer that stop happening and you to go merrily along your way and make your fortune doing whatever it is you choose to do next. Coz by now you know that if you keep poking me in the ribs, I'll keep throwing you under the bus.

" Believe it or not I had a harder time installing 3-tabs then dimensionals. "

???? That's usually the case

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.

theroofmedic Said: NICE Job Twill59- In Arizona you are required to have a Roofing contractors License, (you have to past a knowledge, skill and business test), background check, be bonded, carry workers 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 didnt stop bad contractors or halt fraud but it did slow it way down.

In a place where it rarely rains and never snows (below the mountains anyway)....... :laugh: Licensed or not........at least roofing is a challenge here B)

Meanwhile back at the ranch, in the real world of haildom, it is common for an independent adjuster from OK to come beebopping into Tx, wanting to pay $20/SQR below the going rate in Lubbock because he has roofers out of Tulsa that will do it for that. Happens a lot.

The equation for insurance companies is a simple one: Collect more in premium than you pay out in claims. Every ins co CEO knows that one of the best ways to improve profits to his shareholders or members, is to keep a cap on the claims paid.

Thinking that this is anything but the fox in charge of the henhouse, is usually the position of the fox.

And Nick, I detect a tone of sarcasm. If you come wandering into my playpen from AZ and start trying to take my toys, expect me to exploit your inexperience at every turn. Welcome to the roofing bidnuz, podnah.

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.

Ultimately, my business is not a good fit for insurance work for the following reasons: 1) We actually have roofing insurance 2) We carry work comp on THE FIELD WORKERS 3) As a quality oriented company, our customers will never get dumped on. Yes, I will walk from Bassturds 4) We are a roofing company NOT a sales organization. Our goal is not just getting the job, but to do it as well as possible

Contractors RAISING their prices for insurance work? I've always dropped mine :dry:

That said there are ways to squeeze some lemonade from the lemons: GO cheeeeeeep as possible on underlayments. Re-use as much flashing as possible. Minimize the ventilation. (Using IKO's won't help cut any costs :laugh:) Minimal warranty. That's OK, it won't leak. NEVER tear-off the felt paper to the deck

One thing we will do, no matter how little is paid, is nail correctly, as it is hard to move to the JOKE THAT IS THE STANDARD IN THE ROOFING INDUSTRY after nailing correctly on our other work. (Just by doing that our quality is higher than 2/3 of the jobs that are out there, irregardless of how many other shortcuts we take) We will cut back to 4 nails instead of the usual 5

I can play the game if necessary. I just stress to the customer that you are getting what the insurance company is paying for and it ain't much.

Do any of them listen? :laugh: :laugh: :laugh: YES they do! They actually heard the word "FREE!"

This customer here was exceptional. he was so embarrassed by State Farm, he actually paid me an additional $360 out of his pocket over the Ins settlement

GSD, egg-friggin-zactly!!! Just try bucking Xactimate on a hail claim.

Anyone think Xactimate was adopted for any reason other than controlling claims costs? If so, I have a pallet of diesel engine spark-plugs I'll see you dirt cheap.

Exactly right they set the prices! I've seen it 49 bazillion times - independent adjusters come waltzing into Lubbock from OKC and want to use the prices they've been using in OKC. If you refuse, as often as not one of their storm trooper friends mysteriously gets the contract because he IS willing to use OKC prices.

I have been saying for years that the insurance industry regularly violates anti-trust laws and that one day someone will nail them for a 9-figure amount in a lawsuit. I try not to be an opportunist, and I dislike lawsuits, but I have watched carefully and documented several instances where an insurance company has strung themselves out a miler wide legally.

My dad started his insurance adjusting career in the 1960's, specializing in bull hauler accidents (cattle hauling semis). He said they would do nearly anything to avoid court because it was impossible to get an impartial jury because every citizen in the midwest has had to drive behind a cattle truck sloshing manure all over the highway. Same goes for finding an impartial jury in a suit against an ins company I would think, because everybody has been dorked by an insurance company at some point.

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.

theroofmedic Said: A market with contractors bidding on projects, overpriced proposal dont hold water. Mention Insurance claim and its like blood in the water, suddenly prices start skyrocketing. That was my point.

Xactimate has curbed that a bunch. As a roofer, just try explaining to an adjuster why you should get more than his software dictates you deserve.

It's possible that we're arguing about 2 different things. It's not so much about who did what to whom, and who is more to blame for doing something to someone, or who is cheating whom.

My problem with it is that more regulations and more laws is seldom the best solution to any problem. I'm a limited government guy, nearly a Libertarian.

I realize there is a problem but we're using a sledge hammer to drive a thumbtack. The unintended consequences are far more damaging than the problem the insurance industry is trying to solve. In essence they're saying: Our interests are far more important than anyone else's, and we're willing to create a tremendous amount of disruption in order to cure a problem for ourselves which is, statistically tiny.

The number "$80 billion" was tossed around. First, that is an insurance industry number used to try to justify their actions, and I wouldn't be surprised if it's much smaller. According to this '92 stat, it would mean that 1/3 of the premiums the industry collects are involved in fraudulent claims (http://wiki.answers.com/Q/How_big_is_the_insurance_industry_in_the_United_States). Doubtful.

But even if it is $80b, how much of that has been or will be eliminated by new regulations/laws that restrict roofers and insureds? And is that number high enough to justify all the new regulations.

Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety. ---Benjamin Franklin