Before They Say CLAIM DENIED, Be Sure to Call CALRESTCO Out to Help!
If you are like me chances are that you have also heard the words CLAIM DENIED at least one time before and heard similar stories from friends, family, and customers. It’s surprising how often this occurs, how many people call their insurance first, and then go by the instructions of the insurance only. Sometimes people are lucky and get a nice adjuster who is there to help and try to find coverage for the claim. However, more often we find that insurance can try to take advantage of the situation. They send out one of their own in-house vendors who reports back to the insurance and then they reply with, we are sorry to tell you that your claim has been denied. Sometimes it can be easy to forget that insurance is generally looking out for their own interests and their in-house vendors are under contract to do what the insurance wants them to.
When the insurance carrier determines the scope of restoration work, their main goal is cost savings and the scope of work is likely to be inappropriately narrow. That provides incentive for the insurance vendor to complete less than quality work and use less than quality materials.
We try to help whenever and wherever possible for you and your family/friends/clients. Although we cannot wave a magic wand, our family has been providing these services for over 40 years, since 1976, which has given us a superior level of knowledge and expertise when dealing with insurance carriers and claims. We work with you and your insurance to help with claim handling and support 24/7. We help in finding coverage for claim work whenever possible and do everything we can to make sure the insurance covers and pays a claim. We have completed tens of thousands of insurance claim projects over the years. You can always trust that we are on your side. So, whenever you come across water damage, please call CALRESTCO Out to Help!
Questions? Call my father, Jim Monroe, or me, Matt Monroe, anytime at 818-700-7145, email us at office@calrestco.com, or stop by our office for more information & details about The Calrestco Difference.
Water Damage, Sewer Mitigation, or Mold Remediation disrupt the normal pattern of life, and can involve a lot of emotional stress. People often feel confused and vulnerable after events of this type. However, it is important to make good decisions, because you will be living with the results long after the stress and confusion have passed. We believe that the public interest is best served if people have an understanding of their rights and the alternatives available to them when insurance damage and repair work are involved.
Your insurance policy is a CONTRACT between you and the insurance company. It entitles you to certain rights and imposes certain obligations. We have prepared this BILL OF RIGHTS so that you may better understand the policy you have purchased, and how it relates to the repairs you may undertake. The standard Homeowners policy generally contains the same provisions throughout the United States and Canada; here are some of your rights and obligations under its terms:
1. YOU MAY TAKE, AND BE FULLY COMPENSATED FOR, THE COST OF EMERGENCY STEPS TO SAFEGUARD YOUR PROPERTY FROM FURTHER DAMAGE AFTER A LOSS.…in fact you have an obligation to do so under the terms of your policy. The insurance company may not be liable for additional expense if you fail to provide such protection.
2. IF YOU HAVE SECURED ADEQUATE COVERAGE, YOU ARE ENTITLED TO BE PAID FOR THE FAIR COST OF FULLY RESTORING YOUR HOME TO ITS PRE-DAMAGE CONDITION.…however, you are not insured for the repair of unrelated problems, code deficiencies, or prior damage.
3.YOU ARE ENTITLED TO EMPLOY AND SHOULD INSIST UPON A FULLY CERTIFIED AND INSURED REPAIR FIRM OF GOOD REPUTATION. …however, if you do not choose to employ such a firm the consequences and liability for any injury, damage, or other action may rest with you.
4. YOU ARE ENTITLED TO EMPLOY A FIRM WITH SUFFICIENT EXPERIENCE AND STABILITY IN THE COMMUNITY TO STAND BEHIND ITS WORK AND WARRANTY RESPONSIBILITIES. YOU ARE NOT OBLIGATED TO USE THE INSURANCE COMPANY’S PREFERRED VENDOR.…the contract and its performance is strictly between you and the vendor.
5. YOU ARE ENTITLED TO MATERIALS AND WORKMANSHIP FULLY EQUIVALENT TO YOUR EXISTING INSTALLATION IN LIKE KIND AND QUALITY. …the insurance company has no obligation to improve your existing installation.
6.YOU ARE NOT REQUIRED TO ACCEPT THE LOWEST BIDDER. NOWHERE IN YOUR POLICY DO THE WORDS “CHEAPEST”, “LOW”, OR “LOWEST PRICE” OCCUR.. …however, repair rates should correspond to prevailing standards in your area for work of good quality.
7. YOU ARE ENTITLED TO AND SHOULD REJECT ANY CONTRACT THAT DOES NOT INCORPORATE ALL FEDERAL, STATE AND LOCAL REQUIREMENTS. …however, you must be familiar with these requirements in order to enjoy the protection the law provides. Ask us about this important information.
8. YOU ARE ENTITLED TO SELECT A FIRM WHO CAN DEMONSTRATE SKILL AND EXPERIENCE IN INSURANCE DAMAGE REPAIR AS A FULL TIME PROFESSIONAL SERVICE. …ask for references, credentials, and association membership that indicate professional training and status in insurance repair, as contrasted with ordinary home improvement work.
9. IF SUBSTANTIAL DISAGREEMENT ARISES BETWEEN YOU AND THE INSURANCE COMPANY OVER THE AMOUNT OF THE LOSS YOU ARE ENTITLED TO REQUEST ARBITRATION (“APPRAISAL”) AS DESCRIBED UNDER THE TERMS OF THE POLICY. LINES 123-140 OF THE STANDARD HOMEOWNERS FORM SPELL OUT THESE PROCEDURES FOR SETTLING DIFFERENCES WITHOUT RESORTING TO LAWSUIT. …the restoration company also is entitled to this provision, which may be invoked at any time prior to settlement, whether or not you have received advanced payments.
10. YOU ARE ENTITLED TO RECEIVE PAYMENT FROM THE INSURANCE COMPANY WITHIN THE TIME SPECIFIED BY THE POLICY AND YOUR STATE INSURANCE REGULATIONS, WHICH ARE DESIGNED TO PREVENT INSURANCE COMPANIES FROM USING DELAY AND PERSONAL HARDSHIP TO COMPEL A LOWER SETTLEMENT. …however, the policy also has time requirements for the policyholder, within which you must prepare and submit your claim. Ask your adjuster or agent about these at the outset, so that you can be in compliance.
SINCE YOU ARE THE POLICYHOLDER, ONLY YOU CAN DEMAND THAT YOUR INSURANCE COMPANY LIVE UP TO ITS OBLIGATIONS UNDER THE POLICY. As a Certified Restoration Professional, we recommend that you do so, out of a strong conviction that fair dealing, good workmanship, and ethical business practices benefit the insurance industry just as they benefit the public at large.
Please Note: This “Bill of Rights” is for educational purposes only. The use of the information contained herein should be done at the best judgement of the consumer. This “Bill of Rights” has no intended objective other than to inform any interested parties as to their rights and/or obligations when involved in an insurance claim.
The largest single investment most consumers make is their home and related property. In order to best protect these assets, it is wise for consumers to understand the homeowner’s insurance market. Consumers should consider the following:
Read your policy carefully and understand the coverage and limits provided. Homeowner’s insurance policies contain sub-limits for various coverage's such as personal property, debris removal, additional living expense, detached fences, garages, etc.
Keep accurate records of renovations and improvements to the structure of your home, as it could affect your need to increase your coverage.
Maintaining a list of all personal property, pictures, and video equipment may help in the case of a loss. The list should be stored away from your home.
Comparison shop for insurance, as not all polices are the same and coverage's and prices vary.
Take time to determine the cost to rebuild or replace your property in today’s market. You can seek an independent evaluation of this cost.
You may select a vendor to repair, replace or rebuild damaged property covered by the insurance policy.
An agent or insurance company may help you establish policy limits that are adequate to rebuild your home.
Once the policy is in force, contact your agent or insurance company immediately if you believe your policy limits may be inadequate. A consumer is entitled to receive information regarding homeowner’s insurance. The following is a limited overview of information that your insurance company can provide:
The information provided herein is not all-inclusive and does not negate or preempt existing California law. If you have any concerns or questions, the officers at our Consumer Hotline are there to help you. Please call them at 1-800-927-HELP (4357) or contact us at [insurance.ca.gov]
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